Provider Demographics
NPI:1548513435
Name:DARNELL, RODNEY LOTE
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:LOTE
Last Name:DARNELL
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 1:129 MEADOW STONE LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-6237
Mailing Address - Country:US
Mailing Address - Phone:336-325-8896
Mailing Address - Fax:
Practice Address - Street 1:105 BUSINESS PARK LN
Practice Address - Street 2:
Practice Address - City:DOBSON
Practice Address - State:NC
Practice Address - Zip Code:27017-9026
Practice Address - Country:US
Practice Address - Phone:336-356-4912
Practice Address - Fax:336-356-4915
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist