Provider Demographics
NPI:1033665534
Name:MENDENHALL, JOANNA DOAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:DOAN
Last Name:MENDENHALL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 MERRIAMS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-6694
Mailing Address - Country:US
Mailing Address - Phone:843-367-7828
Mailing Address - Fax:
Practice Address - Street 1:1481 N HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3332
Practice Address - Country:US
Practice Address - Phone:843-881-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36793183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist