Provider Demographics
NPI:1457638330
Name:CASTELLOE, ANDREW COLEMAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:COLEMAN
Last Name:CASTELLOE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 YADKIN ST.
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-3447
Mailing Address - Country:US
Mailing Address - Phone:704-982-9179
Mailing Address - Fax:704-983-5557
Practice Address - Street 1:320 YADKIN ST.
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-3447
Practice Address - Country:US
Practice Address - Phone:704-982-9179
Practice Address - Fax:704-983-5557
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12557183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist