Provider Demographics
NPI:1699073213
Name:SKAFIDAS, JOANNE MARIA (RPH)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:MARIA
Last Name:SKAFIDAS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 RIVER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8355
Mailing Address - Country:US
Mailing Address - Phone:336-712-8012
Mailing Address - Fax:336-712-9587
Practice Address - Street 1:1485 RIVER RIDGE DR
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8355
Practice Address - Country:US
Practice Address - Phone:336-712-8012
Practice Address - Fax:336-712-9587
Is Sole Proprietor?:No
Enumeration Date:2011-03-06
Last Update Date:2011-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08930183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist