Provider Demographics
NPI:1265815443
Name:ARMSTRONG, TERESA BRADSHER
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:BRADSHER
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:JEAN
Other - Last Name:BRADSHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1005 N MADISON BLVD
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573-4529
Mailing Address - Country:US
Mailing Address - Phone:336-599-0851
Mailing Address - Fax:336-599-6194
Practice Address - Street 1:1005 N MADISON BLVD
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-4529
Practice Address - Country:US
Practice Address - Phone:336-599-0851
Practice Address - Fax:336-599-6194
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist