Provider Demographics
NPI:1184225963
Name:DOVERSPIKE, DENA (PHARM D)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:DOVERSPIKE
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 1:1324 CUDDINGTON LN
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-2685
Mailing Address - Country:US
Mailing Address - Phone:407-353-8718
Mailing Address - Fax:
Practice Address - Street 1:3227 OLD FOREST RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2325
Practice Address - Country:US
Practice Address - Phone:434-200-9535
Practice Address - Fax:434-200-9132
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist