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NPI Code Detail

MEDICARE: MICHAEL WARD R.PH.

MEDICARE:   MICHAEL  WARD  R.PH.
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
1183500000XPharmacist049733NY
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistI049733-01NY

General Provider Information

NPI Number : 1437331683
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL WARD R.PH.
Provider Business Mailing Address
First Line : USA MEDDAC
Second Line : 11050 MOUNT BELVEDERE BLVD
City : FORT DRUM
State : NY
Zip : 13602-3101
Country : US
Telephone Number : 315-772-5652
Fax Number :
Provider Business Practice Location Address
First Line : 1729 STATE ST
Second Line :
City : WATERTOWN
State : NY
Zip : 13601-3101
Country : US
Telephone Number : 315-788-3570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2007
Last Update Date : 01/24/2022

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