Provider Demographics
NPI:1124426820
Name:GRIFFIN, WINDY RENE' (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:WINDY
Middle Name:RENE'
Last Name:GRIFFIN
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 1:3152 S NC HIGHWAY 87
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-9787
Mailing Address - Country:US
Mailing Address - Phone:336-675-5481
Mailing Address - Fax:
Practice Address - Street 1:204 LIBERTY PLZ
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:27298-9668
Practice Address - Country:US
Practice Address - Phone:336-622-2364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12440183500000X
LA022071183500000X
NC19616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist