MEDICARE: STACEY WENDLING PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	42752	SC
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH025955	GA

General Provider Information

NPI Number	:	1902404734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY WENDLING PHARMD

Provider Business Mailing Address
First Line	:	5354 REYNOLDS ST STE 103
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6008
Country	:	US
Telephone Number	:	912-819-7559
Fax Number	:	912-819-6961

Provider Business Practice Location Address
First Line	:	5354 REYNOLDS ST STE 103
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6008
Country	:	US
Telephone Number	:	912-819-7559
Fax Number	:	912-819-6961

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2020
Last Update Date	:	05/26/2026

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Directions to “ STACEY WENDLING PHARMD” Practice Location

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