Healthcare Provider Details

I. General information

NPI: 1447401229
Provider Name (Legal Business Name): WESLEY WAYNE HOWARD PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2008
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 KY ROUTE 550
EASTERN KY
41622-6925
US

IV. Provider business mailing address

327 KY ROUTE 550
EASTERN KY
41622-6925
US

V. Phone/Fax

Practice location:
  • Phone: 606-358-4800
  • Fax: 606-358-9706
Mailing address:
  • Phone: 606-358-4800
  • Fax: 606-358-9706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number012893
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: