Provider Demographics
NPI:1689843617
Name:GRIFFIN, NED WILSON (PHARMD)
Entity Type:Individual
Prefix:
First Name:NED
Middle Name:WILSON
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 CROASDAILE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2500
Mailing Address - Country:US
Mailing Address - Phone:919-383-7495
Mailing Address - Fax:919-383-7955
Practice Address - Street 1:2726 CROASDAILE DR STE 104
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2500
Practice Address - Country:US
Practice Address - Phone:919-383-7495
Practice Address - Fax:919-383-7955
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-24
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0760380001Medicaid