MEDICARE: WESCLARE CORPORATION

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
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1174417927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESCLARE CORPORATION

Provider Business Mailing Address
First Line	:	3 NICKMAN PLZ
Second Line	:
City	:	LEMONT FURNACE
State	:	PA
Zip	:	15456-9732
Country	:	US
Telephone Number	:	724-780-2021
Fax Number	:	844-309-9254

Provider Business Practice Location Address
First Line	:	6039 NATIONAL PIKE
Second Line	:
City	:	GRINDSTONE
State	:	PA
Zip	:	15442-1107
Country	:	US
Telephone Number	:	724-785-4522
Fax Number	:	724-785-2863

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAMES WESLEY NICKMAN JR.
Credential	:
Telephone Number	:	724-780-2021

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/05/2025

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Directions to “WESCLARE CORPORATION ” Practice Location

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