Provider Demographics
NPI:1497270672
Name:BASILE, ANNE MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:BASILE
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 1:9201 UNIVERSITY CITY BLVD
Mailing Address - Street 2:STUDENT HEALTH CENTER PHARMACY
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28223-5803
Mailing Address - Country:US
Mailing Address - Phone:704-687-7359
Mailing Address - Fax:704-687-1797
Practice Address - Street 1:9201 UNIVERSITY CITY BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28223-5803
Practice Address - Country:US
Practice Address - Phone:704-687-7359
Practice Address - Fax:704-687-1797
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist