Durham, Charles Wesley
Durham, Charles Wesley is an sole proprietor health care provider with primary practice located at 3495 Piedmont Rd Ne Bldg 9 , Atlanta GA 30305-1729. He recently has 4 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacy Technician, Student, Health Care / Student in an Organized Health Care Education/Training Program, Eye and Vision Services Providers / Optician, Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist. Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist is his primary health care specialty. Durham, Charles Wesley can be contacted via phone (703) 439-4986.Contact Information
Primary practice address
3495 Piedmont Rd Ne Bldg 9
Atlanta GA 30305-1729
Phone: (703) 439-4986
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacy Technician | 183700000X | PHI-015156 | Georgia |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Eye and Vision Services Providers / Optician | 156FX1800X | LDO002227 | Georgia |
| Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 0202212968 | Virginia |
Profile Details
| NPI number | 1235431495 |
|---|---|
| LBN Legal business name | Durham, Charles Wesley |
| Credentials | PHARMD, BCPS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 21st, 2010 |
| Last updated | Oct 19th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235431495 | NPPES |
| Georgia | Other | LDO002227 | STATE LICENSE |
| Georgia | Other | 0202212968 | STATE LICENSE |
| Georgia | Other | PHI-015156 | STATE LICENSE |
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