Provider Demographics
NPI:1346576378
Name:AGUAYO, DOREENE ROXANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DOREENE
Middle Name:ROXANNE
Last Name:AGUAYO
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 1:8225 FOXTRAIL DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-8915
Mailing Address - Country:US
Mailing Address - Phone:910-907-8250
Mailing Address - Fax:910-907-8443
Practice Address - Street 1:WOMACK ARMY MEDICAL CTR
Practice Address - Street 2:DEPARTMENT OF PHARMACY, CLINICAL PHARMACY
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-5000
Practice Address - Country:US
Practice Address - Phone:910-907-8250
Practice Address - Fax:910-907-8443
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH0000491941835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist