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General NPI Number Information
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NPI Number | 1437342946
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Entity Type | Individual
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Provider Name | SALLY DUANN VANDERSLICE R.PH., BCNP, FAPHA
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Gender | Female
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 08/20/2007
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Provider Practice Location Address
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Address Line | 3601 MORGANTOWN INDUSTRIAL PARK
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City | MORGANTOWN
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State | WV
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Zip | 26501-2346
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Country | US
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Telephone | 304-215-3512
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Fax | 304-292-8642
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Provider Business Mailing Address
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Address Line | 3601 MORGANTOWN INDUSTRIAL PARK
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City | MORGANTOWN
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State | WV
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Zip | 26501-2346
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Country | US
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Telephone | 304-215-3512
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Fax | 304-292-8642
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS 30248
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | RP0007024
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | 03-1-20943
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | 12921
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | 26017733
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | 0202011669
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License Number State | VA
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Taxonomy #7
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Taxonomy Code | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | 2001014313
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License Number State | MO
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Taxonomy #8
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Taxonomy Code | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | RP046130R
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License Number State | PA
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