MEDICARE: GREGORY WADE WHEELER RPH

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	183500000X	Pharmacist	0202012206	VA

General Provider Information

NPI Number	:	1285647909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY WADE WHEELER RPH

Provider Business Mailing Address
First Line	:	2951 WEST FRONT STREET
Second Line	:	SUITE 1850
City	:	RICHANDS
State	:	VA
Zip	:	24641-0000
Country	:	US
Telephone Number	:	276-596-6600
Fax Number	:	276-596-6626

Provider Business Practice Location Address
First Line	:	2951 FRONT ST
Second Line	:	SUITE 1850
City	:	RICHLANDS
State	:	VA
Zip	:	24641-2055
Country	:	US
Telephone Number	:	276-596-6600
Fax Number	:	276-596-6626

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/09/2007

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