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General NPI Number Information
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NPI Number | 1205170073
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Entity Type | Individual
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Provider Name | KEVIN SCOTT WOOD PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 11/19/2012
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Provider Practice Location Address
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Address Line | 795 CUMMINGS STREET
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City | ABINGDON
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State | VA
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Zip | 24211
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Country | US
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Telephone | 276-258-5251
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Fax | 276-258-5289
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Provider Business Mailing Address
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Address Line | P.O. BOX 2405 795 CUMMINGS STREET
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City | ABINGDON
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State | VA
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Zip | 24211
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Country | US
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Telephone | 276-258-5211
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Fax | 276-258-5289
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202012264
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License Number State | VA
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