Provider Demographics
NPI:1811574049
Name:HILL, TARA ELAINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:ELAINE
Last Name:HILL
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 1:9805 ROCKY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-8922
Mailing Address - Country:US
Mailing Address - Phone:704-494-3466
Mailing Address - Fax:
Practice Address - Street 1:9805 ROCKY RIVER RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-8922
Practice Address - Country:US
Practice Address - Phone:704-494-3466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21580183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist