Provider Demographics
NPI:1548512189
Name:HILL, MIRANDA GRADY (PHARMD)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:GRADY
Last Name:HILL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DOCTORS DR
Mailing Address - Street 2:SUITE P
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1589
Mailing Address - Country:US
Mailing Address - Phone:252-523-3187
Mailing Address - Fax:252-522-2988
Practice Address - Street 1:701 DOCTORS DR
Practice Address - Street 2:SUITE P
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1589
Practice Address - Country:US
Practice Address - Phone:252-523-3187
Practice Address - Fax:252-522-2988
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist