Provider Demographics
NPI:1447061429
Name:CAULDER, MADISON MILLER
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MILLER
Last Name:CAULDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-9484
Mailing Address - Country:US
Mailing Address - Phone:910-461-7774
Mailing Address - Fax:
Practice Address - Street 1:901 S 401 BYPASS HWY
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5089
Practice Address - Country:US
Practice Address - Phone:910-277-7771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist