Provider Demographics
NPI:1801039334
Name:FUGLEBERG, SAMANTHA TULINO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:TULINO
Last Name:FUGLEBERG
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 1:315 STROMER DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2754
Mailing Address - Country:US
Mailing Address - Phone:321-536-1717
Mailing Address - Fax:
Practice Address - Street 1:1210 KILDAIRE FARM RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5524
Practice Address - Country:US
Practice Address - Phone:919-388-4454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19409183500000X
FL38771183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist