DR. CHARLES WESLEY DURHAM (NPI# 1235431495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235431495 |
| Entity Type | Individual |
| Full Name | DR. CHARLES WESLEY DURHAM |
| Credential | PHARMD, BCPS |
| Practice Address |
22370 Davis Dr Ste 190 Sterling VA 20164-5367 |
| Practice Telephone | 7034394986 |
| Mailing Telephone | 7034394986 |
| Enumeration Date | 2010-11-21 |
| Last Update Date | 2018-02-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 156FX1800X |
Technician/Technologist Specialization: Optician |
LDO002227 | GA | Eye and Vision Services Providers |
| N | 183700000X | Pharmacy Technician | PHI-015156 | GA | Pharmacy Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
0202212968 | VA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | STATE LICENSE | PHI-015156 | 01 |
| GA | STATE LICENSE | LDO002227 | 01 |
| VA | STATE LICENSE | 0202212968 | 01 |
| Street Address |
22370 DAVIS DR STE 190 |
| City | STERLING |
| State | VA |
| Zip Code | 20164-5367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043797285 | Richard Logan Altizer | Pharmacist | 22370 Davis Dr Ste 190, Sterling, VA 20164-5367 | 2018-07-20 |
| 1083956247 | Donna Matthias | Pharmacist | 22370 Davis Dr Ste 190, Sterling, VA 20164-5367 | 2013-03-26 |
| 1679814008 | Stacey Lee Wilcox | Pharmacist | 22370 Davis Dr Ste 190, Sterling, VA 20164-5367 | 2013-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255962239 | Ying Jiu Liu | Acupuncturist | 45665 W Church Rd #110 Stering, Stering, VA 20164 | 2020-01-29 |
| 1417599986 | Nab Homecare, Inc. | In Home Supportive Care | 45640 Willow Pond Plaza, Suite 100, Sterling, VA 20164 | 2019-10-16 |
| 1962905323 | Grace A Oluwadiya | Registered Nurse | 21335 Signal Hill Plaza, Suite 270, Sterling, VA 20164 | 2018-03-13 |
| 1922468602 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 21399 Epicerie Plaza, Sterling, VA 20164 | 2016-02-24 |
| 1942625603 | Totalmobility LLC | Durable Medical Equipment & Medical Supplies | 201 Davis Drive, Suite Nn, Sterling, VA 20164 | 2014-03-04 |
| 1346689189 | Traci Collier | Pharmacist | 22375 Davis Dr, Sterling, VA 20164 | 2013-06-14 |
| 1770842536 | Costco Pharmacy 218 | Clinic/Center | 21398 Price Cascades Plaza, Sterling, VA 20164 | 2012-05-14 |
| 1922371426 | Totalmobility, LLC | Durable Medical Equipment & Medical Supplies | 111k Carpenter Drive, Sterling, VA 20164 | 2012-02-14 |
| 1750676789 | Sheikh M Rasul | Pharmacist | 20600 Great Falls Plaza, Sterling, VA 20164 | 2011-06-17 |
| 1932260114 | Veena Railan | Family Medicine | 101 E.holly Avenue, Unit 9, Sterling, VA 20164 | 2006-12-12 |
| Find all providers in zip 20164 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558663955 | Hope Murphy | Pharmacist | 725 E State St, Sterling, MI 48659-9548 | 2010-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295363984 | Vandorn Apothecary | Pharmacist | 5724 Edsall Rd, Alexandria, VA 22304-4712 | 2020-03-30 |
| 1285261701 | Kimberly Varney | Pharmacist | 401 N 12th St Dept Of, Richmond, VA 23298-5035 | 2020-03-25 |
| 1124651641 | Wintana T Tekleab | Pharmacist | 1201 S Eads St Apt 314, Arlington, VA 22202-2837 | 2020-02-13 |
| 1114557519 | Phillip Ryan Gray | Pharmacist | 2821 Hicks Road, North Chesterfield, VA 23235-0000 | 2020-01-24 |
| 1447880109 | Sara Hudson | Pharmacist | 2821 Hicks Rd, North Chesterfield, VA 23235 | 2020-01-22 |
| 1053951301 | Christina Debra O'neal | Pharmacist | 6460 Grand Retreat Drive Apt 3037, Roanoke, VA 24019 | 2020-01-14 |
| 1609413376 | Laurie Ferguson Mauthe | Pharmacist | 5801 Pollard Dr, Richmond, VA 23226-1830 | 2019-12-02 |
| 1386124303 | Thomas W Taylor | Pharmacist | 240 Mclaws Circle, Suite 147, Williamsburg, VA 23185-2318 | 2018-08-20 |
| 1659886539 | Oscar Macapobre | Pharmacist | 1620 Cedar Rd Ste 100, Chesapeake, VA 23322-7197 | 2017-12-13 |
| 1598139040 | Tina Kathryn Brockman | Pharmacist | 3420 Chaparral Dr, Apt 232, Roanoke, VA 24018-4903 | 2015-11-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.