Provider Demographics
NPI:1649578154
Name:URQUHART, BETSEY DERR (RPH)
Entity Type:Individual
Prefix:MISS
First Name:BETSEY
Middle Name:DERR
Last Name:URQUHART
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 1:3218 EASTOVER RIDGE DR
Mailing Address - Street 2:APT 424
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1455
Mailing Address - Country:US
Mailing Address - Phone:074-377-6679
Mailing Address - Fax:
Practice Address - Street 1:544 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1602
Practice Address - Country:US
Practice Address - Phone:704-377-1556
Practice Address - Fax:704-549-8391
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10562183500000X
VA0202012399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist