Provider Demographics
NPI:1982911061
Name:LYNCH, JUSTIN PATRICK (PHARM D)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:PATRICK
Last Name:LYNCH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 E DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-8813
Mailing Address - Country:US
Mailing Address - Phone:336-629-7034
Mailing Address - Fax:336-626-6928
Practice Address - Street 1:1107 E DIXIE DR
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-8813
Practice Address - Country:US
Practice Address - Phone:336-629-7034
Practice Address - Fax:336-626-6928
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist