Individual
BIANCA XIOMARA LASCANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2125 CLOVERDALE AVE, WINSTON SALEM, NC 27103-2506
(336) 723-0561
Mailing address
4000 CLUBHOUSE CT APT 2G, HIGH POINT, NC 27265-8194
(757) 284-6004
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
29749
NC
183500000X
Pharmacist
NA
VA
Other
Enumeration date
06/26/2018
Last updated
09/01/2020
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