Individual
MR. ALAN GREY BANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3478 E BROAD ST, STATESVILLE, NC 28625-4523
(704) 878-6681
(704) 878-6684
Mailing address
116 MORNING DOVE LN, STATESVILLE, NC 28625-2709
(704) 876-8707
(704) 878-6684
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
05610
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0496471
—
NC
Enumeration date
10/17/2006
Last updated
07/09/2007
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