Provider Demographics
NPI:1629670385
Name:SONA, DEVIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:SONA
Suffix:
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 1:120 SAM WALTON DR
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42276-9311
Mailing Address - Country:US
Mailing Address - Phone:270-726-2966
Mailing Address - Fax:
Practice Address - Street 1:120 SAM WALTON DR
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:KY
Practice Address - Zip Code:42276-9311
Practice Address - Country:US
Practice Address - Phone:270-726-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist