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General NPI Number Information
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NPI Number | 1861804882
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Entity Type | Individual
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Provider Name | TYLER WHALEY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/25/2014
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Last Update Date | 05/25/2014
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Provider Practice Location Address
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Address Line | 3032 MAHONING RD NE
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City | CANTON
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State | OH
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Zip | 44705-3336
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Country | US
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Telephone | 330-454-2877
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Fax |
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Provider Business Mailing Address
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Address Line | 2053 CANYON RD SE
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City | CARROLLTON
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State | OH
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Zip | 44615-8100
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Country | US
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Telephone | 330-324-6009
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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 | 03232738
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License Number State | OH
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