Provider Demographics
NPI:1891393625
Name:ALLEYNE, ANDREA F (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:F
Last Name:ALLEYNE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:F
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3310 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547-1409
Mailing Address - Country:US
Mailing Address - Phone:609-339-9214
Mailing Address - Fax:
Practice Address - Street 1:1395D WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6663
Practice Address - Country:US
Practice Address - Phone:917-937-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC29954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC29954OtherNORTH CAROLINA STATE BOARD