Provider Demographics
NPI:1225445562
Name:LAWRENCE, ELEANOR FARRELL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:FARRELL
Last Name:LAWRENCE
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 1:15090 IDLEWILD RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-3653
Mailing Address - Country:US
Mailing Address - Phone:704-882-4051
Mailing Address - Fax:
Practice Address - Street 1:822 W PENSACOLA ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-8036
Practice Address - Country:US
Practice Address - Phone:850-841-1049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35691183500000X
KY020345183500000X
OH03438224183500000X
FLPS62310183500000X
NC24437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist