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General NPI Number Information
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NPI Number | 1932721966
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Entity Type | Individual
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Provider Name | WENDAL GENE SPEAKE RPH
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Gender | Male
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Dates
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Enumeration Date | 05/13/2020
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 104 1ST ST NW
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City | HAMPTON
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State | IA
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Zip | 50441-1702
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Country | US
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Telephone | 641-456-2510
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Fax | 641-456-4984
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Provider Business Mailing Address
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Address Line | 906 1ST AVE SE
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City | HAMPTON
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State | IA
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Zip | 50441-2217
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Country | US
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Telephone | 641-425-5561
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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 | 17288
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License Number State | IA
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