Provider Demographics
NPI:1730494071
Name:LENHART, PHYLLIS KETNER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:KETNER
Last Name:LENHART
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 1:9900 POPLAR TENT RD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-9502
Mailing Address - Country:US
Mailing Address - Phone:704-789-9602
Mailing Address - Fax:704-795-4266
Practice Address - Street 1:9900 POPLAR TENT RD
Practice Address - Street 2:SUITE 124
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-9502
Practice Address - Country:US
Practice Address - Phone:704-789-9602
Practice Address - Fax:704-795-4266
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist