Provider Demographics
NPI:1548660780
Name:THORNTON, MAEGAN LEE
Entity type:Individual
Prefix:DR
First Name:MAEGAN
Middle Name:LEE
Last Name:THORNTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 W C ST
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:NC
Mailing Address - Zip Code:28339-2626
Mailing Address - Country:US
Mailing Address - Phone:910-897-0586
Mailing Address - Fax:
Practice Address - Street 1:801 S 13TH ST
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:NC
Practice Address - Zip Code:28339-2635
Practice Address - Country:US
Practice Address - Phone:910-897-5014
Practice Address - Fax:910-897-2801
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist