Provider Demographics
NPI:1871878579
Name:LANE, LORIE ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LORIE
Middle Name:ANN
Last Name:LANE
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 1:6802 W WILKINSON BLVD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-6204
Mailing Address - Country:US
Mailing Address - Phone:704-829-5681
Mailing Address - Fax:704-829-5687
Practice Address - Street 1:6802 W WILKINSON BLVD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-6204
Practice Address - Country:US
Practice Address - Phone:704-829-5681
Practice Address - Fax:704-829-5687
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21461183500000X
GARPH021773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist