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NPI Code Detail

MEDICARE: JOHN WILLIAM ANDERSON

MEDICARE: JOHN WILLIAM ANDERSON
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
1183500000XPharmacist4587WY

General Provider Information

NPI Number : 1689207433
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN WILLIAM ANDERSON
Provider Business Mailing Address
First Line : 70 GATEWAY BLVD
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-5709
Country : US
Telephone Number : 307-382-2536
Fax Number :
Provider Business Practice Location Address
First Line : 70 GATEWAY BLVD
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-5709
Country : US
Telephone Number : 307-382-2536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2020
Last Update Date : 09/12/2025

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