Provider Demographics
NPI:1518508670
Name:VANDIVER, IVER O'NEAL II (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:IVER
Middle Name:O'NEAL
Last Name:VANDIVER
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8370 WOLF LAKE DR STE 107
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-7108
Mailing Address - Country:US
Mailing Address - Phone:800-318-6108
Mailing Address - Fax:877-362-3924
Practice Address - Street 1:8370 WOLF LAKE DR STE 107
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-7108
Practice Address - Country:US
Practice Address - Phone:800-318-6108
Practice Address - Fax:877-362-3924
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29465183500000X
NY067500183500000X
LAPST.023832183500000X
AL21056183500000X
COPHA.0023070183500000X
KY022438183500000X
MSE-14979183500000X
NE17304183500000X
ORRPH-0018671183500000X
MI5302414359183500000X
NV23672183500000X
TX62272183500000X
FLPS60564183500000X
TN42991183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist