Provider Demographics
NPI:1538592613
Name:FOSTER, LAQUASHA P (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAQUASHA
Middle Name:P
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1090 S MAIN ST
Mailing Address - Street 2:T2134
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-7440
Mailing Address - Country:US
Mailing Address - Phone:336-992-1681
Mailing Address - Fax:336-992-1691
Practice Address - Street 1:1090 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7440
Practice Address - Country:US
Practice Address - Phone:336-992-1681
Practice Address - Fax:336-992-1691
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist