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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134309339 NPPES
New York MEDICAID 01117995

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