Provider Demographics
NPI:1396452371
Name:TREADWAY, MADISON TAYLOR (PHARMD)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:TAYLOR
Last Name:TREADWAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1928 HEISSER LN
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-3279
Mailing Address - Country:US
Mailing Address - Phone:828-390-9607
Mailing Address - Fax:
Practice Address - Street 1:3333 NC HIGHWAY 242 N
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504-7844
Practice Address - Country:US
Practice Address - Phone:919-894-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC296161835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care