Provider Demographics
NPI:1184966731
Name:MURRAY, WENDY MARIE (CPHT)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:MARIE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:CPHT
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 1098
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24505-1098
Mailing Address - Country:US
Mailing Address - Phone:434-947-6156
Mailing Address - Fax:434-947-2988
Practice Address - Street 1:521 COLONY RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:24572-2105
Practice Address - Country:US
Practice Address - Phone:434-947-6156
Practice Address - Fax:434-947-2988
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230018273183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician