Provider Demographics
NPI:1912257916
Name:MEADS, LAWRENCE CRAIG (BS PHARMACY)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:CRAIG
Last Name:MEADS
Suffix:
Gender:M
Credentials:BS PHARMACY
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 2020
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-2020
Mailing Address - Country:US
Mailing Address - Phone:828-681-2086
Mailing Address - Fax:828-862-6885
Practice Address - Street 1:210 FOREST GATE CTR
Practice Address - Street 2:
Practice Address - City:PISGAH FOREST
Practice Address - State:NC
Practice Address - Zip Code:28768-7710
Practice Address - Country:US
Practice Address - Phone:828-862-6885
Practice Address - Fax:828-862-6885
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC05084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC05084OtherSTATE LICENSE NUMBER