Provider Demographics
NPI:1235472085
Name:MANNING, CHARLES (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:MANNING
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 1:1900 MATTHEWS TOWNSHIP PKWY
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4660
Mailing Address - Country:US
Mailing Address - Phone:909-200-5002
Mailing Address - Fax:
Practice Address - Street 1:9789 CHARLOTTE HWY
Practice Address - Street 2:SUITE 400-182
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707-7177
Practice Address - Country:US
Practice Address - Phone:909-200-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-30
Last Update Date:2013-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist