Provider Demographics
NPI:1821778523
Name:MAYLE, SYDNEY (PHARM D)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:MAYLE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3938 AMELIA PARK DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-7406
Mailing Address - Country:US
Mailing Address - Phone:614-361-9219
Mailing Address - Fax:
Practice Address - Street 1:1371 E BROAD ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-1966
Practice Address - Country:US
Practice Address - Phone:919-567-7426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist