Provider Demographics
NPI:1942502711
Name:DRAYTON, ELLIE G (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELLIE
Middle Name:G
Last Name:DRAYTON
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 1:3420 SW DURHAM DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3351
Mailing Address - Country:US
Mailing Address - Phone:919-403-6985
Mailing Address - Fax:919-403-6992
Practice Address - Street 1:3420 SW DURHAM DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3351
Practice Address - Country:US
Practice Address - Phone:919-403-6985
Practice Address - Fax:919-403-6992
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist