Provider Demographics
NPI:1639497100
Name:GOLD, WENDY MARLA (RPH)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:MARLA
Last Name:GOLD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 ROSS RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-4221
Mailing Address - Country:US
Mailing Address - Phone:603-799-9012
Mailing Address - Fax:
Practice Address - Street 1:250 COMMERCIAL ST STE 2012
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1118
Practice Address - Country:US
Practice Address - Phone:855-745-5725
Practice Address - Fax:603-935-9108
Is Sole Proprietor?:No
Enumeration Date:2010-05-08
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236416183500000X
FLPS32081183500000X
NH3070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist