Provider Demographics
NPI:1053722520
Name:COLEY, MARY GRACE FITTS (PHARMD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:GRACE FITTS
Last Name:COLEY
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 1:1050 ALAMANCE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1050 ALAMANCE CHURCH RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3808
Practice Address - Country:US
Practice Address - Phone:336-804-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-18
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist