Provider Demographics
NPI:1669774394
Name:MORGAN, LONNIE TIMOTHY (RPH)
Entity type:Individual
Prefix:MR
First Name:LONNIE
Middle Name:TIMOTHY
Last Name:MORGAN
Suffix:
Gender:M
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:PO BOX 660
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:NC
Mailing Address - Zip Code:27915-0660
Mailing Address - Country:US
Mailing Address - Phone:252-995-3811
Mailing Address - Fax:252-995-7955
Practice Address - Street 1:41934 HWY 12
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:NC
Practice Address - Zip Code:27915-0660
Practice Address - Country:US
Practice Address - Phone:252-995-3811
Practice Address - Fax:252-995-7955
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08457183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist