Provider Demographics
NPI:1134161060
Name:DELLINGER, DAVID LARRY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LARRY
Last Name:DELLINGER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 SHELBY RD
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-2742
Mailing Address - Country:US
Mailing Address - Phone:704-739-1698
Mailing Address - Fax:
Practice Address - Street 1:1106 SHELBY RD
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-2742
Practice Address - Country:US
Practice Address - Phone:704-739-1698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703620Medicaid
NC0235855Medicaid
NC7703620Medicaid