Provider Demographics
NPI:1912729807
Name:ALLEN, CANDICE (PHARMD)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:
Other - Last Name:FORWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:171 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9500
Mailing Address - Country:US
Mailing Address - Phone:704-660-4000
Mailing Address - Fax:
Practice Address - Street 1:1361 MIFFLIN LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:NC
Practice Address - Zip Code:28034-9654
Practice Address - Country:US
Practice Address - Phone:810-701-9878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist