Provider Demographics
NPI:1467744433
Name:MCIVER, ANN SHEPHERD (RPH)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:SHEPHERD
Last Name:MCIVER
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 1:3500 WAKE FOREST RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7307
Mailing Address - Country:US
Mailing Address - Phone:919-855-5694
Mailing Address - Fax:919-855-5699
Practice Address - Street 1:3500 WAKE FOREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7307
Practice Address - Country:US
Practice Address - Phone:919-855-5694
Practice Address - Fax:919-855-5699
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC06286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist