Individual
CHARLES NMI VANDIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH., PH.C.
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
PC00000033
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4458
REGISTERED PHARMACIST #
NM
01
—
CS00021140
NM CONTROLLED SUBST. NUM
NM
01
—
PC00000033
PHARMACIST CLINICIAN NUM
NM
Enumeration date
07/13/2006
Last updated
03/07/2023
Update your record
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