Provider Demographics
NPI:1184030785
Name:FEJZULLAHU, FATMIR (PHARMACISTRPH)
Entity type:Individual
Prefix:
First Name:FATMIR
Middle Name:
Last Name:FEJZULLAHU
Suffix:
Gender:M
Credentials:PHARMACISTRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8180 S TRYON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-3325
Mailing Address - Country:US
Mailing Address - Phone:704-588-9796
Mailing Address - Fax:704-729-6217
Practice Address - Street 1:8180 S TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-3325
Practice Address - Country:US
Practice Address - Phone:704-588-9796
Practice Address - Fax:704-729-6217
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist