Healthcare Provider Details

I. General information

NPI: 1053535658
Provider Name (Legal Business Name): OLWYN MARIE WHEELER BSPHARM, PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: OLWYN MARIE WHEELER BSPHARM, PHARMD

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 11/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 COURT DR
GASTONIA NC
28054-2140
US

IV. Provider business mailing address

4709 S HILL VIEW DR
CHARLOTTE NC
28210-2331
US

V. Phone/Fax

Practice location:
  • Phone: 704-834-2308
  • Fax: 704-834-3030
Mailing address:
  • Phone: 704-965-7350
  • Fax: 704-381-7171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13165
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: