Provider Demographics
NPI:1215203120
Name:GADDIS, EMILY (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:GADDIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-3921
Mailing Address - Country:US
Mailing Address - Phone:704-735-2791
Mailing Address - Fax:704-735-2697
Practice Address - Street 1:2130 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3921
Practice Address - Country:US
Practice Address - Phone:704-735-2791
Practice Address - Fax:704-735-2697
Is Sole Proprietor?:No
Enumeration Date:2012-03-25
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21838183500000X
TN36293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist