Connor Bradley Alcide, PHARM.D
Individual provider Active NPI Pharmacist · Ayden, NC
NPI 1194292003 · NPPES record last updated Oct 29, 2018
Key facts
- NPI
- 1194292003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28310 (NC)
- Practice address
- 140 NC 102 W
Ayden, NC 28513-8792 - Phone
- (252) 746-3026
- NPI assigned
- Oct 29, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS58473 | FL | MD | Pharmacist |
| 28310 | NC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS58473 | FL | |
| Pharmacist | 183500000X | 28310 | NC | Yes |
Addresses
Primary practice location
140 NC 102 W
Ayden, NC 28513-8792
Mailing address
1220 Treybrooke Cir
Greenville, NC 27834-9137
Phone (704) 477-4563
Other providers in Ayden, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.