Lori Culicerto, PHARM D – Pharmacist in Charlotte, NC

Key facts

NPI: 1578898045
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 16718 (NC)
Practice address: 4701 South Blvd
Charlotte, NC 28217-2117
Phone: (704) 523-3227
Fax: (704) 523-8468
NPI assigned: Oct 16, 2009
Sex: Female
Sole proprietor: Yes

Organizations & group practices 2

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.

Walgreen Co Pharmacy · Charlotte, NC · NPI 1558376657

NPD (past)
Walgreen Co Pharmacy · Longview, TX · NPI 1629956545

NPD (past)

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
10856	SC	MD	Social Worker
16718	NC	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
Walgreen Co		Past	Accepting new patients
Walgreen Co		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	16718	NC	Yes
Pharmacist	183500000X	10856	SC

Addresses

Primary practice location

4701 South Blvd
Charlotte, NC 28217-2117

Mailing address

635 Diana Dr
Charlotte, NC 28203-5610
Phone (704) 676-5025

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 16, 2009.

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255651200000",
    "number": "1578898045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 DIANA DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035610",
            "telephone_number": "704-676-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 SOUTH BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172117",
            "telephone_number": "704-523-3227",
            "fax_number": "704-523-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULICERTO",
        "first_name": "LORI",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2009-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "16718",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "10856",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

All providers in Charlotte, NC · Pharmacist in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2009. 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.

Verify at the official NPI Registry.