Provider Demographics
NPI:1558730796
Name:GRAHAM, ANNA WEAVER (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:WEAVER
Last Name:GRAHAM
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 1:6310 BURLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WHITSETT
Mailing Address - State:NC
Mailing Address - Zip Code:27377-9233
Mailing Address - Country:US
Mailing Address - Phone:336-449-0294
Mailing Address - Fax:
Practice Address - Street 1:6310 BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:WHITSETT
Practice Address - State:NC
Practice Address - Zip Code:27377-9233
Practice Address - Country:US
Practice Address - Phone:336-449-0294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist