Provider Demographics
NPI:1659130367
Name:SMITH, CYNTHIA GLENDORA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:GLENDORA
Last Name:SMITH
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 1:1803 MAYS CHAPEL ROAD
Mailing Address - Street 2:
Mailing Address - City:BEAR CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:27207
Mailing Address - Country:US
Mailing Address - Phone:919-704-5344
Mailing Address - Fax:
Practice Address - Street 1:1803 MAYS CHAPEL ROAD
Practice Address - Street 2:
Practice Address - City:BEAR CREEK
Practice Address - State:NC
Practice Address - Zip Code:27207
Practice Address - Country:US
Practice Address - Phone:919-704-5344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist