Provider Demographics
NPI:1609292150
Name:GARIBALDI, ASHLY (PHARM D)
Entity Type:Individual
Prefix:
First Name:ASHLY
Middle Name:
Last Name:GARIBALDI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 KERWICK CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-6454
Mailing Address - Country:US
Mailing Address - Phone:504-812-0779
Mailing Address - Fax:
Practice Address - Street 1:4400 GOLF ACRES DR
Practice Address - Street 2:SUITE E BUILDING J
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5990
Practice Address - Country:US
Practice Address - Phone:704-512-4227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19185183500000X
LA18422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist