Provider Demographics
NPI:1689793572
Name:SAVARYN-WICKS, ROXANNE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:
Last Name:SAVARYN-WICKS
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 1:1826 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-4232
Mailing Address - Country:US
Mailing Address - Phone:605-692-2033
Mailing Address - Fax:
Practice Address - Street 1:127 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:FLANDREAU
Practice Address - State:SD
Practice Address - Zip Code:57028-1222
Practice Address - Country:US
Practice Address - Phone:605-997-2122
Practice Address - Fax:605-997-5408
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist