Provider Demographics
NPI:1487012324
Name:WINGARD, DONNIE ALAN JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:DONNIE
Middle Name:ALAN
Last Name:WINGARD
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 COASTAL CRAB RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8368
Mailing Address - Country:US
Mailing Address - Phone:843-327-5056
Mailing Address - Fax:
Practice Address - Street 1:3630 COASTAL CRAB RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-8368
Practice Address - Country:US
Practice Address - Phone:843-327-5056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-07
Last Update Date:2016-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist