Provider Demographics
NPI:1598462541
Name:RUDISILL, TAYLOR LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LEE
Last Name:RUDISILL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 OLDE DUFFERS DR
Mailing Address - Street 2:
Mailing Address - City:NEBO
Mailing Address - State:NC
Mailing Address - Zip Code:28761-7780
Mailing Address - Country:US
Mailing Address - Phone:828-358-7855
Mailing Address - Fax:
Practice Address - Street 1:756 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3941
Practice Address - Country:US
Practice Address - Phone:828-245-0786
Practice Address - Fax:828-245-5509
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31695183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist