Provider Demographics
NPI:1447545298
Name:LACHAKE, SUNANDA H
Entity type:Individual
Prefix:
First Name:SUNANDA
Middle Name:H
Last Name:LACHAKE
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 1:9101 MATTHEWS-PINEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134
Mailing Address - Country:US
Mailing Address - Phone:704-542-5153
Mailing Address - Fax:704-341-4698
Practice Address - Street 1:9101 MATTHEWS-PINEVILLE RD
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134
Practice Address - Country:US
Practice Address - Phone:704-542-5153
Practice Address - Fax:704-341-4698
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16580183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist