Provider Demographics
NPI:1174509327
Name:SIMPLER, WENDY PERRY (CPHT)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:PERRY
Last Name:SIMPLER
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2851
Mailing Address - Country:US
Mailing Address - Phone:334-793-1316
Mailing Address - Fax:334-793-4920
Practice Address - Street 1:4119 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1023
Practice Address - Country:US
Practice Address - Phone:334-793-1316
Practice Address - Fax:334-793-4920
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL110100318207626183700000X
ALT03093183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician