=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457649964
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WENDY ANN ALVANOS PHARM D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2011
-----------------------------------------------------
Last Update Date | 07/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 NOR DAN DR STE 1010
-----------------------------------------------------
City | DANVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24540-1658
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-441-4252
-----------------------------------------------------
Fax | 910-267-0082
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 707 HARTHER DR
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28540-9221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-626-7448
-----------------------------------------------------
Fax | 910-267-0082
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 0202220273
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 21870
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------