Provider Demographics
NPI:1396021721
Name:NAYLOR, CHERISH TART (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHERISH
Middle Name:TART
Last Name:NAYLOR
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 1:307 BEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2907
Mailing Address - Country:US
Mailing Address - Phone:910-592-8444
Mailing Address - Fax:910-592-6505
Practice Address - Street 1:307 BEAMAN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2907
Practice Address - Country:US
Practice Address - Phone:910-592-8444
Practice Address - Fax:910-592-6505
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0825281Medicaid
NCQ36805AOtherMEDICARE PTAN
NC3429621Medicare UPIN
NC0463350001Medicare NSC