Provider Demographics
NPI:1508378662
Name:BATCHELOR, CANDI WATERS (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:CANDI
Middle Name:WATERS
Last Name:BATCHELOR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:CANDI
Other - Middle Name:DAWN
Other - Last Name:WATERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:209 SOUTHERLAND RD
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NC
Mailing Address - Zip Code:28508-9452
Mailing Address - Country:US
Mailing Address - Phone:252-939-6126
Mailing Address - Fax:
Practice Address - Street 1:4459 TARHEEL DR
Practice Address - Street 2:
Practice Address - City:PINK HILL
Practice Address - State:NC
Practice Address - Zip Code:28572-9649
Practice Address - Country:US
Practice Address - Phone:252-568-9945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18266183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist