Provider Demographics
NPI:1033272240
Name:PHARES, TERESA SPINE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:SPINE
Last Name:PHARES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 AMBER WOOD RUN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-4494
Mailing Address - Country:US
Mailing Address - Phone:919-960-4249
Mailing Address - Fax:
Practice Address - Street 1:501 HAMPTON PT
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-9012
Practice Address - Country:US
Practice Address - Phone:919-732-9181
Practice Address - Fax:919-732-6218
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4483183500000X
NC9543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist