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General NPI Number Information
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NPI Number | 1639189798
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Entity Type | Organization
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Legal Business Name | WOODROW WILSON REHBILITATION CENTER
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 243 WOODROW WILSON AVE
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City | FISHERSVILLE
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State | VA
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Zip | 22939
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Country | US
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Telephone | 154-033-7087
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1500 BOX W-1
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City | FISHERSVILLE
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State | VA
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Zip | 22939
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Country | US
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Telephone | 154-033-7087
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. RICK L SIZEMORE
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Credential |
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Telephone | 540-332-7451
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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 | 0201000981
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License Number State | VA
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