Provider Demographics
NPI:1720539679
Name:FUTRELL, JODY BECK (RPH)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:BECK
Last Name:FUTRELL
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 1:160 LOWES BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-5347
Mailing Address - Country:US
Mailing Address - Phone:336-249-8481
Mailing Address - Fax:336-249-7570
Practice Address - Street 1:160 LOWES BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-5347
Practice Address - Country:US
Practice Address - Phone:336-249-8481
Practice Address - Fax:336-249-7570
Is Sole Proprietor?:No
Enumeration Date:2016-10-16
Last Update Date:2016-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist