Provider Demographics
NPI:1891042891
Name:GAINES, HOWARD COLMUS (PHARM D)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:COLMUS
Last Name:GAINES
Suffix:
Gender:M
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:PO BOX 44088
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-0035
Mailing Address - Country:US
Mailing Address - Phone:704-589-3065
Mailing Address - Fax:704-537-1891
Practice Address - Street 1:4300 NORTH CAROLINA HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-7527
Practice Address - Country:US
Practice Address - Phone:704-455-6422
Practice Address - Fax:704-454-5124
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist