Provider Demographics
NPI:1235489006
Name:MARLOW, KENDALL GRIZZARD (PHARMD)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:GRIZZARD
Last Name:MARLOW
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 1:1628 HIGHWOODS BLVD
Mailing Address - Street 2:T-2108
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2048
Mailing Address - Country:US
Mailing Address - Phone:336-455-9901
Mailing Address - Fax:336-252-5679
Practice Address - Street 1:1628 HIGHWOODS BLVD
Practice Address - Street 2:T-2108
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2048
Practice Address - Country:US
Practice Address - Phone:336-455-9901
Practice Address - Fax:336-252-5679
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist