Provider Demographics
NPI:1790881787
Name:CLEVELAND, WENDY WHITE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:WHITE
Last Name:CLEVELAND
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 1:511 SOUTH NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150
Mailing Address - Country:US
Mailing Address - Phone:256-245-1707
Mailing Address - Fax:
Practice Address - Street 1:33404 US HWY 280
Practice Address - Street 2:
Practice Address - City:CHILDERSBURG
Practice Address - State:AL
Practice Address - Zip Code:35044
Practice Address - Country:US
Practice Address - Phone:256-378-5727
Practice Address - Fax:256-378-3743
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12656183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist