Provider Demographics
NPI:1144374489
Name:HARTSELL, TAMALA JANE (RPH)
Entity type:Individual
Prefix:MS
First Name:TAMALA
Middle Name:JANE
Last Name:HARTSELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10987 FLOWES STORE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28107-9419
Mailing Address - Country:US
Mailing Address - Phone:704-455-6651
Mailing Address - Fax:704-455-3651
Practice Address - Street 1:REMEDY SHOPPE PHARMACY
Practice Address - Street 2:925-1 SUNSET COMMONS SEASIDE RD SW
Practice Address - City:OCEAN ISLE BEACH
Practice Address - State:NC
Practice Address - Zip Code:28469
Practice Address - Country:US
Practice Address - Phone:910-575-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10192183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist