Provider Demographics
NPI:1760638506
Name:ELDRIDGE, RENEE ELLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:ELLEN
Last Name:ELDRIDGE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 US HIGHWAY 70 E
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-7500
Mailing Address - Country:US
Mailing Address - Phone:919-732-6263
Mailing Address - Fax:919-644-0312
Practice Address - Street 1:200 US HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-7500
Practice Address - Country:US
Practice Address - Phone:919-732-6263
Practice Address - Fax:919-644-0312
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist