Provider Demographics
NPI:1326703547
Name:DECKER, CHELSEA L (PHARM D)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:L
Last Name:DECKER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:L
Other - Last Name:DEZANET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2653 WYNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-8005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3917 WESTPOINT BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6723
Practice Address - Country:US
Practice Address - Phone:800-524-7083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist