Amy Elizabeth Tetro-Wenger, RPH

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0202215239 Issued in VA

Practice address

24585 Stone Carver Dr Ste 175
Aldie, VA 20105-2798

Phone

(571) 367-3914

Fax

(703) 542-6788

NPI assigned

Oct 11, 2018

Last updated

Oct 11, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Theodore LLC

  dba Ted Pharmacy

  • Community/Retail Pharmacy
  • Aldie, VA
  • NPI 1659860500
  NPD (past)
• St Theodore LLC

  dba Ted Pharmacy

  • Long Term Care Pharmacy
  • Aldie, VA
  • NPI 1710618129
  NPD (past)

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1386119774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24585 STONE CARVER DR STE 175",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201052798",
            "telephone_number": "571-367-3914",
            "fax_number": "703-542-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24585 STONE CARVER DR STE 175",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201052798",
            "telephone_number": "571-367-3914",
            "fax_number": "703-542-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETRO-WENGER",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "RP00005569",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "18446",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0202215239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ehab Tadrous
• Mahesh Kumar Tawney, PHARM.D.
• Amber Leigh Taylor, DPT, PT
• Leilani A Taylor
• Teachspeech, LLC
• Stephanie B. Tran
• Tree of Life Family Services, LLC
• Austin N Trought
• United State Home Healthcare LLC
• Diego Varela, PA-C

• Community/Retail Pharmacy in Aldie, VA
• Providers in Aldie, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.