Provider Demographics
NPI:1871944389
Name:COMBS, CHANDLER QUINTESSENCE (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:CHANDLER
Middle Name:QUINTESSENCE
Last Name:COMBS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:STOKESDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27357-0063
Mailing Address - Country:US
Mailing Address - Phone:336-644-7288
Mailing Address - Fax:336-644-7291
Practice Address - Street 1:8500 US HIGHWAY 158
Practice Address - Street 2:
Practice Address - City:STOKESDALE
Practice Address - State:NC
Practice Address - Zip Code:27357-9248
Practice Address - Country:US
Practice Address - Phone:336-644-7288
Practice Address - Fax:336-644-7291
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25942183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist