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General NPI Number Information
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NPI Number | 1346576378
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Entity Type | Individual
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Provider Name | DOREENE ROXANNE AGUAYO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/27/2009
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Last Update Date | 10/27/2009
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Provider Practice Location Address
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Address Line | WOMACK ARMY MEDICAL CTR DEPARTMENT OF PHARMACY, CLINICAL PHARMACY
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City | FORT BRAGG
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State | NC
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Zip | 28310-5000
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Country | US
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Telephone | 910-907-8250
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Fax | 910-907-8443
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Provider Business Mailing Address
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Address Line | 8225 FOXTRAIL DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-8915
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Country | US
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Telephone | 910-907-8250
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Fax | 910-907-8443
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PH000049194
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License Number State | WA
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