Provider Demographics
NPI:1467882845
Name:FORDJOUR, RAYMOND (PHARMD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:FORDJOUR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3431 MATTHEWS MINT HILL RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4030
Mailing Address - Country:US
Mailing Address - Phone:704-844-6990
Mailing Address - Fax:
Practice Address - Street 1:3431 MATTHEWS MINT HILL RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4030
Practice Address - Country:US
Practice Address - Phone:704-844-6990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23100183500000X
MD18591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist