Provider Demographics
NPI:1225331358
Name:VARNER, LAURIE CARROLL (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:CARROLL
Last Name:VARNER
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 1:616 BAYBUSH DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3181
Mailing Address - Country:US
Mailing Address - Phone:919-847-4781
Mailing Address - Fax:919-847-4857
Practice Address - Street 1:8345 CREEDMOOR RD # D
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1385
Practice Address - Country:US
Practice Address - Phone:919-848-4191
Practice Address - Fax:919-676-6866
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-11
Last Update Date:2010-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist