Provider Demographics
NPI:1447796495
Name:DEAL, PAULETTE (RPH)
Entity Type:Individual
Prefix:
First Name:PAULETTE
Middle Name:
Last Name:DEAL
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 1:242 MONTE VISTA RD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-2327
Mailing Address - Country:US
Mailing Address - Phone:704-500-8811
Mailing Address - Fax:704-872-6462
Practice Address - Street 1:1116 CROSSROADS DR
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-8277
Practice Address - Country:US
Practice Address - Phone:704-871-9824
Practice Address - Fax:704-872-6462
Is Sole Proprietor?:No
Enumeration Date:2017-01-15
Last Update Date:2017-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist