Provider Demographics
NPI:1548508377
Name:WADSWORTH, CHANDA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHANDA
Middle Name:
Last Name:WADSWORTH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:HAYESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28904-0012
Mailing Address - Country:US
Mailing Address - Phone:828-361-5876
Mailing Address - Fax:828-389-2832
Practice Address - Street 1:230 HIGHWAY 64 E
Practice Address - Street 2:
Practice Address - City:HAYESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28904-5526
Practice Address - Country:US
Practice Address - Phone:828-389-2804
Practice Address - Fax:828-389-2832
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18034183500000X
GARPH024126183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist