Provider Demographics
NPI:1871906560
Name:SUDDERTH, TAMIKA WRIGHT (RPH)
Entity type:Individual
Prefix:MS
First Name:TAMIKA
Middle Name:WRIGHT
Last Name:SUDDERTH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 EASTCHESTER DR
Mailing Address - Street 2:SUITE 121
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7731
Mailing Address - Country:US
Mailing Address - Phone:336-869-5747
Mailing Address - Fax:336-869-5758
Practice Address - Street 1:265 EASTCHESTER DR
Practice Address - Street 2:SUITE 121
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7731
Practice Address - Country:US
Practice Address - Phone:336-869-5747
Practice Address - Fax:336-869-5758
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist