Provider Demographics
NPI:1043516362
Name:MASON, GAIL L (RPH)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:L
Last Name:MASON
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 1:13845 CONLAN CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2705
Mailing Address - Country:US
Mailing Address - Phone:704-544-2092
Mailing Address - Fax:704-544-8251
Practice Address - Street 1:13845 CONLAN CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2705
Practice Address - Country:US
Practice Address - Phone:704-544-2092
Practice Address - Fax:704-544-8251
Is Sole Proprietor?:No
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist