Provider Demographics
NPI:1760600746
Name:TEACHEY, TAMMY PHIPPS
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:PHIPPS
Last Name:TEACHEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 E STRAWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28457-8055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5220 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7056
Practice Address - Country:US
Practice Address - Phone:910-791-2346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist