Provider Demographics
NPI:1699057158
Name:ZAMPARELLI, EDNA KOKO (PHARM D)
Entity type:Individual
Prefix:
First Name:EDNA
Middle Name:KOKO
Last Name:ZAMPARELLI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 W FRONT ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-3734
Mailing Address - Country:US
Mailing Address - Phone:704-307-8555
Mailing Address - Fax:
Practice Address - Street 1:901 SOUTH MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253
Practice Address - Country:US
Practice Address - Phone:336-229-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21805183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist