Doctor Name: | MRS. IVY JACKIE SANDERS |
NPI Number: | 1164713426 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 28514 |
Business Practice Address: | 4761 Ward Blvd Wilson, NC - 278934359 |
Business Phone Number: | 2523992112 |
Business Fax Number: | 2523992136 |
Mailing Address: | 4761 Ward Blvd, WILSON |
State: | NC |
Postal Code: | 278934359 |
Phone Number: | 2523992112 |
Fax Number: | 2523992136 |
NPI Enumeration Date: | 04/21/2011 |
NPI Last Update Date: | 04/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 183700000X |
License Number: | 28514 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacy Technician |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |