Provider Demographics
NPI:1710758552
Name:MARSH, LANE ALEXANDER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LANE
Middle Name:ALEXANDER
Last Name:MARSH
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 1:2305 BRANDT VLG
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2169
Mailing Address - Country:US
Mailing Address - Phone:903-372-8121
Mailing Address - Fax:
Practice Address - Street 1:2835 REYNOLDA RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3110
Practice Address - Country:US
Practice Address - Phone:336-723-6462
Practice Address - Fax:336-722-4617
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist