Deverna, Susan L
Deverna, Susan L is an individual health care provider with primary practice located at 3341 Mountain Hill Dr , Wake Forest NC 27587-9752. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Deverna, Susan L can be contacted via phone (516) 297-0293.Contact Information
Primary practice address
3341 Mountain Hill Dr
Wake Forest NC 27587-9752
Phone: (516) 297-0293
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 041675 | New York |
| Pharmacy Service Providers / Pharmacist | 183500000X | 25379 | North Carolina |
Profile Details
| NPI number | 1134309339 |
|---|---|
| LBN Legal business name | Deverna, Susan L |
| Credentials | RPH. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 6th, 2007 |
| Last updated | Jan 14th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134309339 | NPPES |
| New York | MEDICAID | 01117995 |
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