Roy Oswald Vandevender
Pharmacist in Philadelphia, MS. Individual provider (NPI-1).
NPI number1346842010
StatusActive
Last updated in NPPESNov 9, 2020
Details
- NPI
- 1346842010
- Entity type
- Individual (NPI-1)
- Name
- Roy Oswald Vandevender
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 9, 2020
- Certification date
- Nov 9, 2020
- Last updated
- Nov 9, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | e-07808 | MS | Yes |
Practice location
1002 W Beacon StPhiladelphia, MS 39350-3204
Phone 601-656-5312 · Fax 601-656-5312
Mailing address
Po Box 187De Kalb, MS 39328-0187
Phone 601-692-7922
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