Provider Demographics
NPI:1700111937
Name:CREECH, CARL RUFUS (PHARMD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:RUFUS
Last Name:CREECH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ROBESON ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-5552
Mailing Address - Country:US
Mailing Address - Phone:910-615-1808
Mailing Address - Fax:910-486-2143
Practice Address - Street 1:101 ROBESON ST
Practice Address - Street 2:SUITE 107
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-5552
Practice Address - Country:US
Practice Address - Phone:910-615-1808
Practice Address - Fax:910-486-2143
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7009183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist