Provider Demographics
NPI:1689208001
Name:HARRELL, WENDY (RPH)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:HARRELL
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:PO BOX I
Mailing Address - Street 2:
Mailing Address - City:PINETOPS
Mailing Address - State:NC
Mailing Address - Zip Code:27864-0090
Mailing Address - Country:US
Mailing Address - Phone:252-827-5532
Mailing Address - Fax:252-827-2741
Practice Address - Street 1:102 W HAMLET
Practice Address - Street 2:
Practice Address - City:PINETOPS
Practice Address - State:NC
Practice Address - Zip Code:27864-0090
Practice Address - Country:US
Practice Address - Phone:252-827-5532
Practice Address - Fax:252-827-2741
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist