Healthcare Provider Details

I. General information

NPI: 1013846823
Provider Name (Legal Business Name): MICHAEL PAUL WARDEN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 COLEGATE DR
MARIETTA OH
45750-1323
US

IV. Provider business mailing address

515 MASONIC PARK RD
MARIETTA OH
45750-1042
US

V. Phone/Fax

Practice location:
  • Phone: 740-568-2038
  • Fax:
Mailing address:
  • Phone: 740-568-2038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03331483
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: