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General NPI Number Information
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NPI Number | 1245848399
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Entity Type | Individual
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Provider Name | BRIAN WENGER PHARMD, BCPS
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Gender | Male
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 593 EDDY ST
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City | PROVIDENCE
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State | RI
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Zip | 02903-4923
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Country | US
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Telephone | 401-444-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 21 E TRANSIT ST APT 2
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City | PROVIDENCE
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State | RI
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Zip | 02906-6019
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Country | US
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Telephone | 815-272-0839
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Fax |
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | RPH06754
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License Number State | RI
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