Provider Demographics
NPI:1083906788
Name:VALENTINE, KARL S (RPH)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:S
Last Name:VALENTINE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6028 S NC 16 HWY
Mailing Address - Street 2:
Mailing Address - City:MAIDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28650-8114
Mailing Address - Country:US
Mailing Address - Phone:704-483-9133
Mailing Address - Fax:704-483-1438
Practice Address - Street 1:6028 S NC 16 HWY
Practice Address - Street 2:
Practice Address - City:MAIDEN
Practice Address - State:NC
Practice Address - Zip Code:28650-8114
Practice Address - Country:US
Practice Address - Phone:704-483-9133
Practice Address - Fax:704-483-1438
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0004294183500000X
NC25811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist