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General NPI Number Information
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NPI Number | 1649878018
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Entity Type | Individual
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Provider Name | THOMAS ROBERT WARWICK
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Gender | Male
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Dates
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Enumeration Date | 10/16/2020
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Last Update Date | 10/16/2020
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Provider Practice Location Address
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Address Line | 130 COMMERCE ST
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City | WISCONSIN DELLS
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State | WI
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Zip | 53965-8263
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Country | US
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Telephone | 608-253-5662
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Fax |
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Provider Business Mailing Address
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Address Line | E10047A BUCK BAY W
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City | REEDSBURG
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State | WI
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Zip | 53959-9629
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Country | US
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Telephone | 608-393-1547
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10034-40
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License Number State | WI
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