Provider Demographics
NPI:1134437494
Name:HERNANDEZ-PARBUS, MIRELLA (RPH)
Entity type:Individual
Prefix:MS
First Name:MIRELLA
Middle Name:
Last Name:HERNANDEZ-PARBUS
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 1:3573 HILLSBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705
Mailing Address - Country:US
Mailing Address - Phone:919-414-6853
Mailing Address - Fax:919-383-0171
Practice Address - Street 1:3573 HILLSBOROUGH ROAD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705
Practice Address - Country:US
Practice Address - Phone:919-383-0171
Practice Address - Fax:919-384-9641
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14206183500000X
NY040233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14206OtherNCBOP LICENSE NUMBER