Provider Demographics
NPI:1598093197
Name:SEUFERT, ROY JOSEPH (ROY SEUFERT RPH)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:JOSEPH
Last Name:SEUFERT
Suffix:
Gender:M
Credentials:ROY SEUFERT RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 EDGESIDE CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4660
Mailing Address - Country:US
Mailing Address - Phone:910-764-2058
Mailing Address - Fax:
Practice Address - Street 1:3501 EDGESIDE CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4660
Practice Address - Country:US
Practice Address - Phone:910-764-2058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist