MEDICARE: MS. PATRICIA ANN WILHELM RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03213719	OH

General Provider Information

NPI Number	:	1205126315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ANN WILHELM RPH

Provider Business Mailing Address
First Line	:	318 RIDGEPOINT CIR
Second Line	:
City	:	WATERVILLE
State	:	OH
Zip	:	43566-1604
Country	:	US
Telephone Number	:	419-878-4042
Fax Number	:

Provider Business Practice Location Address
First Line	:	2430 GLENDALE AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2736
Country	:	US
Telephone Number	:	419-382-4912
Fax Number	:	419-381-6778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2011
Last Update Date	:	04/10/2011

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