Provider Demographics
NPI:1063668713
Name:SHARPE, KIM (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:
Last Name:SHARPE
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 1:1050 S HORNER BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-5323
Mailing Address - Country:US
Mailing Address - Phone:919-775-5022
Mailing Address - Fax:919-774-4490
Practice Address - Street 1:1050 S HORNER BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5323
Practice Address - Country:US
Practice Address - Phone:919-775-5022
Practice Address - Fax:919-774-4490
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist