Provider Demographics
NPI:1184850216
Name:GREENE, MYRA COX (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MYRA
Middle Name:COX
Last Name:GREENE
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 1:816 N MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FUQUAY-VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-2067
Mailing Address - Country:US
Mailing Address - Phone:919-552-4248
Mailing Address - Fax:919-552-8965
Practice Address - Street 1:816 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2067
Practice Address - Country:US
Practice Address - Phone:919-552-4248
Practice Address - Fax:919-552-8965
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist