=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942297619
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WARMAN'S PRESCRIPTION SERVICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2005
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1220 GAY ST
-----------------------------------------------------
City | PORTSMOUTH
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45662-3460
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-354-7979
-----------------------------------------------------
Fax | 740-354-2238
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1220 GAY ST P.O. BOX 1111
-----------------------------------------------------
City | PORTSMOUTH
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45662-3460
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-354-7979
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KEN WARMAN
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 740-354-7979
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------