Provider Demographics
NPI:1609056720
Name:HAGWOOD, WENDY ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ANN
Last Name:HAGWOOD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:WENDY
Other - Middle Name:ANN
Other - Last Name:ZIOLKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4500 WESTERN BLVD
Mailing Address - Street 2:KMART PHARMACY #4450
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1814
Mailing Address - Country:US
Mailing Address - Phone:919-851-5247
Mailing Address - Fax:919-859-4357
Practice Address - Street 1:4500 WESTERN BLVD
Practice Address - Street 2:KMART PHARMACY #4450
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-1814
Practice Address - Country:US
Practice Address - Phone:919-851-5247
Practice Address - Fax:919-859-4357
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17733183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist