Provider Demographics
NPI:1467052704
Name:HILDEBRANDT, DARLENE (PHARMD)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:HILDEBRANDT
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 1:2811 WAXHAW MARVIN RD
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-7530
Mailing Address - Country:US
Mailing Address - Phone:479-531-8974
Mailing Address - Fax:
Practice Address - Street 1:10048 CHARLOTTE HWY
Practice Address - Street 2:
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707-7135
Practice Address - Country:US
Practice Address - Phone:803-802-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202215571183500000X
NC30016183500000X
SC43198183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist