Provider Demographics
NPI:1720387293
Name:HOUSE, HEDY ELIZABETH (RPH)
Entity Type:Individual
Prefix:MS
First Name:HEDY
Middle Name:ELIZABETH
Last Name:HOUSE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 J JULIAN LN
Mailing Address - Street 2:APT. F
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-3091
Mailing Address - Country:US
Mailing Address - Phone:704-392-8799
Mailing Address - Fax:
Practice Address - Street 1:1776 STATESVILLE AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-3013
Practice Address - Country:US
Practice Address - Phone:704-371-3727
Practice Address - Fax:704-371-3780
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7358183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist