Provider Demographics
NPI:1336472059
Name:ELLER, ALETHA POPLIN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ALETHA
Middle Name:POPLIN
Last Name:ELLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694-9757
Mailing Address - Country:US
Mailing Address - Phone:336-246-9990
Mailing Address - Fax:336-246-6069
Practice Address - Street 1:1395 W D ST
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3505
Practice Address - Country:US
Practice Address - Phone:336-651-2910
Practice Address - Fax:336-651-2907
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1336472059OtherPERSONAL NPI