Provider Demographics
NPI:1568805133
Name:CHARGUALAF, LAURA MINCEMOYER (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MINCEMOYER
Last Name:CHARGUALAF
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 1:101 MANNING DRIVE
Mailing Address - Street 2:MEMORIAL HOSPITAL 4TH FLOOR
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:984-974-7914
Mailing Address - Fax:434-244-7553
Practice Address - Street 1:101 MANNING DRIVE
Practice Address - Street 2:MEMORIAL HOSPITAL 4TH FLOOR
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:984-974-5100
Practice Address - Fax:984-974-5595
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC246391835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care