Provider Demographics
NPI:1326290891
Name:LEWIS, CAROLINE MOSS (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:MOSS
Last Name:LEWIS
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:PO BOX 29264
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27429-9264
Mailing Address - Country:US
Mailing Address - Phone:828-283-1188
Mailing Address - Fax:828-293-0851
Practice Address - Street 1:1500 CLARENDON DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2955
Practice Address - Country:US
Practice Address - Phone:828-283-1188
Practice Address - Fax:828-293-3041
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist