Provider Demographics
NPI:1689870685
Name:HILL, CHARLES LEROY (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:LEROY
Last Name:HILL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 N WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-5946
Mailing Address - Country:US
Mailing Address - Phone:704-933-6637
Mailing Address - Fax:
Practice Address - Street 1:520 N CANNON BLVD
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-3802
Practice Address - Country:US
Practice Address - Phone:704-938-3187
Practice Address - Fax:704-933-5173
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist