Provider Demographics
NPI:1043366743
Name:DISCO, MARILYN EDITH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:EDITH
Last Name:DISCO
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 1:4201 BUCHANAN DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5291
Mailing Address - Country:US
Mailing Address - Phone:919-401-4345
Mailing Address - Fax:
Practice Address - Street 1:406 RIGSBEE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2186
Practice Address - Country:US
Practice Address - Phone:919-688-4772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC160451835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric