Michael Dimenna, R.PH.

Individual provider Active NPI Pharmacist · Fairview, NC

NPI 1386789451 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1386789451
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
8535 (NC)
Practice address
66 Retta Rd
Fairview, NC 28730-8767
Phone
(828) 628-3675
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cane Creek Pharmacy Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8535 NC Yes

Addresses

Primary practice location

66 Retta Rd
Fairview, NC 28730-8767

Mailing address

1555 NC Highway 9
Black Mountain, NC 28711-9685

Other providers in Fairview, NC

All providers in Fairview, NC · Pharmacist in North Carolina

Sources for this page

Verify at the official NPI Registry.