Provider Demographics
NPI:1316540149
Name:WHITLOW, BETSY B (CPHT)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:B
Last Name:WHITLOW
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 COPPERFIELD BLVD NE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2441
Mailing Address - Country:US
Mailing Address - Phone:704-784-9613
Mailing Address - Fax:
Practice Address - Street 1:270 COPPERFIELD BLVD NE STE 101
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2443
Practice Address - Country:US
Practice Address - Phone:704-784-9613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30120363183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician