Provider Demographics
NPI:1295880516
Name:LASSITER, EMILY KAYE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:KAYE
Last Name:LASSITER
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 1:116 LOG BARN RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-8372
Mailing Address - Country:US
Mailing Address - Phone:704-645-7033
Mailing Address - Fax:704-645-7033
Practice Address - Street 1:2421 SUPERCENTER DR NE
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-6426
Practice Address - Country:US
Practice Address - Phone:704-792-9049
Practice Address - Fax:704-792-9056
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13581183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3440803Medicare UPIN