Provider Demographics
NPI:1487829354
Name:NECESSARY, GWENDOLYN
Entity Type:Individual
Prefix:MRS
First Name:GWENDOLYN
Middle Name:
Last Name:NECESSARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:LORADO
Mailing Address - State:WV
Mailing Address - Zip Code:25630-0047
Mailing Address - Country:US
Mailing Address - Phone:304-583-9708
Mailing Address - Fax:
Practice Address - Street 1:ST. RT. 16
Practice Address - Street 2:
Practice Address - City:LORADO
Practice Address - State:WV
Practice Address - Zip Code:25630-0047
Practice Address - Country:US
Practice Address - Phone:304-583-9708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0003864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist