Provider Demographics
NPI:1902232143
Name:BOLAND, CASSIE LYNNAE LINKER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:LYNNAE LINKER
Last Name:BOLAND
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:PO BOX 159
Mailing Address - Street 2:515 NORTH MAIN STREET
Mailing Address - City:WINGATE
Mailing Address - State:NC
Mailing Address - Zip Code:28174-9662
Mailing Address - Country:US
Mailing Address - Phone:704-233-8336
Mailing Address - Fax:
Practice Address - Street 1:3614 PROVIDENCE RD S
Practice Address - Street 2:STE 200
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-6309
Practice Address - Country:US
Practice Address - Phone:704-384-8640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC189601835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist