Provider Demographics
NPI:1881988772
Name:KAUFFMAN, CANDACE S (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:S
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT COVE
Mailing Address - State:NC
Mailing Address - Zip Code:27052-9248
Mailing Address - Country:US
Mailing Address - Phone:336-591-4351
Mailing Address - Fax:336-591-3053
Practice Address - Street 1:610 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WALNUT COVE
Practice Address - State:NC
Practice Address - Zip Code:27052-9248
Practice Address - Country:US
Practice Address - Phone:336-591-4351
Practice Address - Fax:336-591-3053
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist