Provider Demographics
NPI:1245744523
Name:DREVILA, SVIATLANA M (PHARMD)
Entity Type:Individual
Prefix:
First Name:SVIATLANA
Middle Name:M
Last Name:DREVILA
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 1:1185 CHARLOTTE HWY
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-7782
Mailing Address - Country:US
Mailing Address - Phone:828-683-3121
Mailing Address - Fax:
Practice Address - Street 1:1185 CHARLOTTE HWY
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-7782
Practice Address - Country:US
Practice Address - Phone:828-683-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-26
Last Update Date:2017-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist