Provider Demographics
NPI:1902220726
Name:WYBLE, LORI COE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:COE
Last Name:WYBLE
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 1:116 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-3429
Mailing Address - Country:US
Mailing Address - Phone:336-835-2621
Mailing Address - Fax:336-835-2419
Practice Address - Street 1:116 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-3429
Practice Address - Country:US
Practice Address - Phone:336-835-2621
Practice Address - Fax:336-835-2419
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist