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NPI Code Detail

MEDICARE: MR. JASPER WAYNE WETHINGTON RPH

MEDICARE: MR. JASPER WAYNE WETHINGTON 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
1183500000XPharmacistAA992AK

General Provider Information

NPI Number : 1336199223
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASPER WAYNE WETHINGTON RPH
Provider Business Mailing Address
First Line : 6200 ROCKHILL CIR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-6713
Country : US
Telephone Number : 907-230-4801
Fax Number : 907-743-7257
Provider Business Practice Location Address
First Line : 4951 BUSINESS PARK BOULEVARD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-7174
Country : US
Telephone Number : 907-743-7203
Fax Number : 907-743-7257
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 10/15/2012

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Directions to “ MR. JASPER WAYNE WETHINGTON RPH” Practice Location

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