Provider Demographics
NPI:1861677577
Name:LINE, DAVID SPENCER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SPENCER
Last Name:LINE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2069 21ST ST SE APT O
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-3482
Mailing Address - Country:US
Mailing Address - Phone:704-219-6918
Mailing Address - Fax:
Practice Address - Street 1:625 HARPER AVE SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5250
Practice Address - Country:US
Practice Address - Phone:828-758-8932
Practice Address - Fax:828-754-4530
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist