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General NPI Number Information
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NPI Number | 1801116058
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Entity Type | Individual
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Provider Name | WILLIAM G INNERST RPH
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Gender | Male
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 13 PORT WATSON ST
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City | CORTLAND
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State | NY
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Zip | 13045-2606
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Country | US
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Telephone | 607-753-3230
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Fax |
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Provider Business Mailing Address
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Address Line | 7012 N GLEN HAVEN RD
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City | HOMER
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State | NY
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Zip | 13077-9520
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Country | US
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Telephone | 607-749-2311
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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 | 024892-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP041652R
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License Number State | PA
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