Individual provider Active NPI

Wendy Evans Greenway, RPH

  • Pharmacist
  • Lilburn, GA
National Provider Identifier
1376881474
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17860 Issued in GA
Practice address
4045 Five Forks Trickum Rd SW
Lilburn, GA 30047-2351
Phone
(770) 381-4176
Fax
(770) 381-7559
NPI assigned
Jan 24, 2013
Last updated
Jan 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17860 GA Primary

Addresses

Primary practice location

4045 Five Forks Trickum Rd SW
Lilburn, GA 30047-2351

Mailing address

1434 Braxford Trce
Lawrenceville, GA 30044-6178
Phone (770) 736-7976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1376881474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 BRAXFORD TRCE",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300446178",
            "telephone_number": "770-736-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 FIVE FORKS TRICKUM RD SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472351",
            "telephone_number": "770-381-4176",
            "fax_number": "770-381-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWAY",
        "first_name": "WENDY",
        "middle_name": "EVANS",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "17860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.