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NPI Code Detail

MEDICARE: REBECCA WILSON

MEDICARE: REBECCA WILSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH.03334453-3OH

General Provider Information

NPI Number : 1043687478
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA WILSON
Provider Business Mailing Address
First Line : 1955 CLEVELAND RD
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2256
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1955 CLEVELAND RD
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2256
Country : US
Telephone Number : 330-262-9045
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2015
Last Update Date : 09/02/2015

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Directions to “ REBECCA WILSON ” Practice Location

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