Provider Demographics
NPI:1497372742
Name:ALLWOOD, IMARI AARON
Entity type:Individual
Prefix:DR
First Name:IMARI
Middle Name:AARON
Last Name:ALLWOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4923 RAEFORD RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3141
Mailing Address - Country:US
Mailing Address - Phone:910-273-1120
Mailing Address - Fax:
Practice Address - Street 1:4923 RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3141
Practice Address - Country:US
Practice Address - Phone:910-423-1251
Practice Address - Fax:910-423-5706
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist