Provider Demographics
NPI:1396782132
Name:SENIOR PHARMASSIST
Entity type:Organization
Organization Name:SENIOR PHARMASSIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:UPCHURCH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MPH
Authorized Official - Phone:919-682-4962
Mailing Address - Street 1:406 RIGSBEE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2186
Mailing Address - Country:US
Mailing Address - Phone:919-688-4772
Mailing Address - Fax:
Practice Address - Street 1:406 RIGSBEE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2186
Practice Address - Country:US
Practice Address - Phone:919-688-4772
Practice Address - Fax:919-682-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable