Provider Demographics
NPI:1851686612
Name:GIVENS, DEANA (PHARM D)
Entity Type:Individual
Prefix:
First Name:DEANA
Middle Name:
Last Name:GIVENS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 RHL
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-8278
Mailing Address - Country:US
Mailing Address - Phone:304-743-0820
Mailing Address - Fax:304-746-0820
Practice Address - Street 1:30 RHL
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-8278
Practice Address - Country:US
Practice Address - Phone:304-743-0820
Practice Address - Fax:304-746-0820
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP00006626183500000X
VA0202204799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist