Provider Demographics
NPI:1801415187
Name:GROOMS, TORY STRIDER (PHARMD, CPP)
Entity type:Individual
Prefix:
First Name:TORY
Middle Name:STRIDER
Last Name:GROOMS
Suffix:
Gender:F
Credentials:PHARMD, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10926 S TRYON ST STE D
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4154
Mailing Address - Country:US
Mailing Address - Phone:980-224-7289
Mailing Address - Fax:800-507-2885
Practice Address - Street 1:10926 S TRYON ST STE D
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-4154
Practice Address - Country:US
Practice Address - Phone:980-224-7289
Practice Address - Fax:800-507-2885
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30608183500000X
NC7005251835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist