Provider Demographics
NPI:1538751979
Name:LOCKLEAR, NICHOLAS CLEO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:CLEO
Last Name:LOCKLEAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8047 JOHNS MILL RD
Mailing Address - Street 2:
Mailing Address - City:MAXTON
Mailing Address - State:NC
Mailing Address - Zip Code:28364-9610
Mailing Address - Country:US
Mailing Address - Phone:910-318-4709
Mailing Address - Fax:910-844-3017
Practice Address - Street 1:102 N PATTERSON ST
Practice Address - Street 2:
Practice Address - City:MAXTON
Practice Address - State:NC
Practice Address - Zip Code:28364-1735
Practice Address - Country:US
Practice Address - Phone:910-844-3100
Practice Address - Fax:910-844-3017
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist