Organization
VAXCLINIC, LLC
Active
Other names
VaxClinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMANTHA HOWARD PHARMD (PHARMACIST)
(606) 424-2781
Entity
Organization
Contact information
Practice address
1301 WINCHESTER RD STE 13, LEXINGTON, KY 40505-4132
(606) 424-2781
Mailing address
1521 TAMWORTH DR, CHARLOTTE, NC 28210-4109
(606) 424-2781
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487140901
1487140901
NC
Enumeration date
06/03/2019
Last updated
09/17/2019
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