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General NPI Number Information
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NPI Number | 1629014857
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Entity Type | Organization
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Legal Business Name | WOOD PHARMACY
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 326 N MARKET
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City | MONON
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State | IN
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Zip | 47959
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Country | US
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Telephone | 219-253-8050
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Fax | 219-253-8283
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Provider Business Mailing Address
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Address Line | PO BOX 807
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City | MONON
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State | IN
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Zip | 47959-0807
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE WOOD
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Credential |
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Telephone | 219-253-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 60004975A
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License Number State | IN
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