Provider Demographics
NPI:1558715888
Name:CHEEK, JODY (RPH)
Entity Type:Individual
Prefix:MR
First Name:JODY
Middle Name:
Last Name:CHEEK
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 1:305 TROLLINGER ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-2227
Mailing Address - Country:US
Mailing Address - Phone:336-226-1619
Mailing Address - Fax:336-226-1610
Practice Address - Street 1:305 TROLLINGER ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-2227
Practice Address - Country:US
Practice Address - Phone:336-226-1619
Practice Address - Fax:336-226-1610
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404174OtherNABP
NC1134120017OtherPHARMACY NPI