Provider Demographics
NPI:1790935617
Name:CAWA, ANGELA KOREN (RPH)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KOREN
Last Name:CAWA
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 1:3645 CONCORD PKWY S
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-9054
Mailing Address - Country:US
Mailing Address - Phone:704-723-4948
Mailing Address - Fax:
Practice Address - Street 1:3645 CONCORD PKWY S
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-9054
Practice Address - Country:US
Practice Address - Phone:704-723-4948
Practice Address - Fax:704-723-4965
Is Sole Proprietor?:No
Enumeration Date:2008-09-27
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRX 10890183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist