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General NPI Number Information
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NPI Number | 1891027652
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Entity Type | Individual
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Provider Name | SELENA A KENNADAY PHARM D
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Gender | Female
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 420 FUN CENTER DRIVE WALMART PHARMACY
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City | SURF CITY
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State | NC
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Zip | 28445
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Country | US
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Telephone | 910-803-6003
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Fax | 910-803-6004
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Provider Business Mailing Address
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Address Line | 3475 PARKWAY VILLAGE CIR
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City | WINSTON SALEM
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State | NC
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Zip | 27127-6857
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Country | US
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Telephone | 336-771-9711
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Fax | 336-771-9710
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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 | 21304
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 053530
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License Number State | NY
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