Provider Demographics
NPI:1902191026
Name:LUFT, CHARLOTTE GILLESPIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:GILLESPIE
Last Name:LUFT
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 1:8210 RENAISSANCE PKWY
Mailing Address - Street 2:T-2069
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6688
Mailing Address - Country:US
Mailing Address - Phone:919-425-0002
Mailing Address - Fax:919-237-7169
Practice Address - Street 1:8210 RENAISSANCE PKWY
Practice Address - Street 2:T-2069
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6688
Practice Address - Country:US
Practice Address - Phone:919-425-0002
Practice Address - Fax:919-237-7169
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0326679Medicaid