Provider Demographics
NPI:1306179403
Name:KAPERONIS, TRIANTAPHYLLI PHYLLIS (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TRIANTAPHYLLI
Middle Name:PHYLLIS
Last Name:KAPERONIS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 MURRAYHILL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-4738
Mailing Address - Country:US
Mailing Address - Phone:704-564-8292
Mailing Address - Fax:
Practice Address - Street 1:544 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1602
Practice Address - Country:US
Practice Address - Phone:704-377-1556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17690183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist