Provider Demographics
NPI:1184648446
Name:CONNOLLY, ANNA MARTHA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARTHA
Last Name:CONNOLLY
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:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:304-336-9834
Mailing Address - Fax:888-383-0267
Practice Address - Street 1:216 MOORE RD
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-8703
Practice Address - Country:US
Practice Address - Phone:336-983-4346
Practice Address - Fax:888-383-0267
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7002921835P2201X
NC282721835P2201X, 1835P0018X
WVRP0006897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist