Provider Demographics
NPI:1700202322
Name:FERRELL, DONALD
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:FERRELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 ARROWHEAD RD
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-9798
Mailing Address - Country:US
Mailing Address - Phone:828-884-6462
Mailing Address - Fax:
Practice Address - Street 1:228 ARROWHEAD RD
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-9798
Practice Address - Country:US
Practice Address - Phone:828-884-6462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07681183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07681OtherNORTH CAROLINA BOARD OF PHARMACY