Provider Demographics
NPI:1427325257
Name:PHARMQUEST, LLC
Entity type:Organization
Organization Name:PHARMQUEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDAL
Authorized Official - Middle Name:
Authorized Official - Last Name:VON SEGGERN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:336-574-8020
Mailing Address - Street 1:806 GREEN VALLEY RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7042
Mailing Address - Country:US
Mailing Address - Phone:336-574-8020
Mailing Address - Fax:336-574-8022
Practice Address - Street 1:806 GREEN VALLEY RD
Practice Address - Street 2:SUITE 305
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7042
Practice Address - Country:US
Practice Address - Phone:336-574-8020
Practice Address - Fax:336-574-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08521261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch