Provider Demographics
NPI:1639490501
Name:DILLON, ANGELA A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:A
Last Name:DILLON
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 1:668 HOSTA DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-8776
Mailing Address - Country:US
Mailing Address - Phone:304-939-0082
Mailing Address - Fax:
Practice Address - Street 1:8532 UNIVERSITY CITY BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-3579
Practice Address - Country:US
Practice Address - Phone:704-549-1593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist