Provider Demographics
NPI:1205386059
Name:TRIPLETT, PRESTON (RPH)
Entity Type:Individual
Prefix:MR
First Name:PRESTON
Middle Name:
Last Name:TRIPLETT
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 1:4418 W WENDOVER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2600
Mailing Address - Country:US
Mailing Address - Phone:336-852-0997
Mailing Address - Fax:336-852-0981
Practice Address - Street 1:4418 W WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-2600
Practice Address - Country:US
Practice Address - Phone:336-852-0997
Practice Address - Fax:336-852-0981
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist