Provider Demographics
NPI:1568053148
Name:PETCHE, LAURA C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:C
Last Name:PETCHE
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:PO BOX 986
Mailing Address - Street 2:
Mailing Address - City:LINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28646-0986
Mailing Address - Country:US
Mailing Address - Phone:828-737-7476
Mailing Address - Fax:828-737-7479
Practice Address - Street 1:436 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LINVILLE
Practice Address - State:NC
Practice Address - Zip Code:28646
Practice Address - Country:US
Practice Address - Phone:828-737-7476
Practice Address - Fax:828-737-7479
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist