Provider Demographics
NPI:1972788206
Name:QUINN, TARA SANDERS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:SANDERS
Last Name:QUINN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 NEW MARKET CTR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-3993
Mailing Address - Country:US
Mailing Address - Phone:828-264-9144
Mailing Address - Fax:828-265-3201
Practice Address - Street 1:245 NEW MARKET CTR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-3993
Practice Address - Country:US
Practice Address - Phone:828-264-9144
Practice Address - Fax:828-265-3201
Is Sole Proprietor?:No
Enumeration Date:2008-01-05
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42064183500000X
TN23919183500000X
NC14467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist