Provider Demographics
NPI:1447636535
Name:PEELE, DEXTER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DEXTER
Middle Name:
Last Name:PEELE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 PINEY WOODS RD
Mailing Address - Street 2:P.O BOX 61
Mailing Address - City:LEWISTON
Mailing Address - State:NC
Mailing Address - Zip Code:27849-9204
Mailing Address - Country:US
Mailing Address - Phone:252-413-8470
Mailing Address - Fax:
Practice Address - Street 1:320 PINEY WOODS RD
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NC
Practice Address - Zip Code:27849-9204
Practice Address - Country:US
Practice Address - Phone:252-413-8470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist