Provider Demographics
NPI:1780969402
Name:DION, CHRISTOPEHR R (RPH)
Entity type:Individual
Prefix:
First Name:CHRISTOPEHR
Middle Name:R
Last Name:DION
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 1:1225 WAYNEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-7947
Mailing Address - Country:US
Mailing Address - Phone:704-668-8559
Mailing Address - Fax:
Practice Address - Street 1:5455 POTTERS RD
Practice Address - Street 2:
Practice Address - City:STALLINGS
Practice Address - State:NC
Practice Address - Zip Code:28104-5990
Practice Address - Country:US
Practice Address - Phone:704-821-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15759183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist