Provider Demographics
NPI:1568964617
Name:LAM-GARDNER, CAROL WU (PHARMD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:WU
Last Name:LAM-GARDNER
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 1:2406 WATERSGLEN DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-6248
Mailing Address - Country:US
Mailing Address - Phone:309-533-4572
Mailing Address - Fax:
Practice Address - Street 1:5141 NC-42 W
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529
Practice Address - Country:US
Practice Address - Phone:919-772-7131
Practice Address - Fax:919-772-7504
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015029078183500000X
NC27559183500000X
WI18028-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist