Provider Demographics
NPI:1003342643
Name:TUDOR, LEA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEA
Middle Name:
Last Name:TUDOR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 US 64 HWY W
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-7184
Mailing Address - Country:US
Mailing Address - Phone:919-380-1443
Mailing Address - Fax:919-380-9822
Practice Address - Street 1:940 US 64 HWY W
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523-7184
Practice Address - Country:US
Practice Address - Phone:919-380-1443
Practice Address - Fax:919-380-9822
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist