Provider Demographics
NPI:1124286075
Name:DILLARD, ALICE SMITH (PHARMACIST)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:SMITH
Last Name:DILLARD
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 EAST HIGHWAY 54
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2197
Mailing Address - Country:US
Mailing Address - Phone:919-544-1711
Mailing Address - Fax:
Practice Address - Street 1:1700 EAST HWY 54
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2197
Practice Address - Country:US
Practice Address - Phone:919-544-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist