Provider Demographics
NPI:1386942761
Name:BREESE, CHRISTOPHER JOHN (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:BREESE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S POST RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-6269
Mailing Address - Country:US
Mailing Address - Phone:980-484-5243
Mailing Address - Fax:800-835-4512
Practice Address - Street 1:200 S POST RD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6269
Practice Address - Country:US
Practice Address - Phone:980-484-5164
Practice Address - Fax:800-835-4512
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist