Healthcare Provider Details

I. General information

NPI: 1215866645
Provider Name (Legal Business Name): WESTON LOWELL NOYES RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 LAGRANGE RD
FREEPORT FL
32439-4500
US

IV. Provider business mailing address

1498 LAGRANGE RD
FREEPORT FL
32439-4500
US

V. Phone/Fax

Practice location:
  • Phone: 850-863-7572
  • Fax: 850-315-0523
Mailing address:
  • Phone: 850-863-7572
  • Fax: 850-315-0523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS21822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: