Provider Demographics
NPI:1902230733
Name:SMITH, LYNN SASSER (PHARMD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:SASSER
Last Name:SMITH
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 1:114 ARIEL ST
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-6154
Mailing Address - Country:US
Mailing Address - Phone:919-222-5966
Mailing Address - Fax:
Practice Address - Street 1:511 N MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:COATS
Practice Address - State:NC
Practice Address - Zip Code:27521-9398
Practice Address - Country:US
Practice Address - Phone:910-230-0247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist