MEDICARE: WILLIAM R. COLEMAN

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	333600000X	Pharmacy	PH00009443	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992701155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM R. COLEMAN

Provider Business Mailing Address
First Line	:	301 S WAPATO AVE
Second Line	:	P.O. BOX 98
City	:	WAPATO
State	:	WA
Zip	:	98951-1346
Country	:	US
Telephone Number	:	509-877-2707
Fax Number	:	509-877-2577

Provider Business Practice Location Address
First Line	:	301 S WAPATO AVE
Second Line	:
City	:	WAPATO
State	:	WA
Zip	:	98951-1346
Country	:	US
Telephone Number	:	509-877-2707
Fax Number	:	509-877-2577

Authorized Official
Title or Position	:	OWNER
Name	:	MR. WILLIAM RICHARD COLEMAN
Credential	:	RPH
Telephone Number	:	509-877-2707

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	06/23/2008

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Directions to “WILLIAM R. COLEMAN ” Practice Location

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