Provider Demographics
NPI:1386922094
Name:LIPSCOMB, WENDY (RPH)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:LIPSCOMB
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 1:110 BOONE SQUARE ST
Mailing Address - Street 2:SUITE 29
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2564
Mailing Address - Country:US
Mailing Address - Phone:919-245-1212
Mailing Address - Fax:919-245-1210
Practice Address - Street 1:110 BOONE SQUARE ST
Practice Address - Street 2:SUITE 29
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2564
Practice Address - Country:US
Practice Address - Phone:919-245-1212
Practice Address - Fax:919-245-1210
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12561183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist