Provider Demographics
NPI:1073686465
Name:GANTT, CHARISE LOWERY (RPH)
Entity type:Individual
Prefix:MRS
First Name:CHARISE
Middle Name:LOWERY
Last Name:GANTT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 TROY HILL DR
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-9446
Mailing Address - Country:US
Mailing Address - Phone:828-684-1559
Mailing Address - Fax:
Practice Address - Street 1:35 WOODFIN ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3020
Practice Address - Country:US
Practice Address - Phone:828-250-5238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7241OtherPHARMACY LICENSE NUMBER