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NPI Code Detail

MEDICARE: DR. JOHNATHEN WOODWARD PHARMD

MEDICARE: DR. JOHNATHEN WOODWARD PHARMD
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist20551NV

General Provider Information

NPI Number : 1336767797
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHNATHEN WOODWARD PHARMD
Provider Business Mailing Address
First Line : 1005 WIGWAM PKWY APT 1206
Second Line :
City : HENDERSON
State : NV
Zip : 89074-8248
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 450 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5304
Country : US
Telephone Number : 702-452-0224
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2020
Last Update Date : 07/10/2020

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Directions to “ DR. JOHNATHEN WOODWARD PHARMD” Practice Location

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