Provider Demographics
NPI:1295015758
Name:GRANGER, JULIE (RPH)
Entity Type:Individual
Prefix:MR
First Name:JULIE
Middle Name:
Last Name:GRANGER
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 1:6212 HAYDEN DR
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-7079
Mailing Address - Country:US
Mailing Address - Phone:828-874-5100
Mailing Address - Fax:828-874-2843
Practice Address - Street 1:721 MALCOLM BLVD
Practice Address - Street 2:
Practice Address - City:CONNELLYS SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28612-7920
Practice Address - Country:US
Practice Address - Phone:828-874-5100
Practice Address - Fax:828-874-2843
Is Sole Proprietor?:No
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist