Provider Demographics
NPI:1619261997
Name:UPTON, JULIE WILSON (RPH)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:WILSON
Last Name:UPTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MATTHEWS TOWNSHIP PKWY
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4660
Mailing Address - Country:US
Mailing Address - Phone:704-846-6902
Mailing Address - Fax:704-846-6902
Practice Address - Street 1:1900 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4660
Practice Address - Country:US
Practice Address - Phone:704-846-6902
Practice Address - Fax:704-846-6902
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15353183500000X
SC8146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist