MEDICARE: WOOD COUNTY COMMUNITY HEALTH AND WELLNESS CENTER PHARMACY

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	3336C0002X	Clinic Pharmacy

General Provider Information

NPI Number	:	1306250410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOOD COUNTY COMMUNITY HEALTH AND WELLNESS CENTER PHARMACY

Provider Business Mailing Address
First Line	:	1840 E GYPSY LANE RD
Second Line	:
City	:	BOWLING GREEN
State	:	OH
Zip	:	43402-9173
Country	:	US
Telephone Number	:	419-354-9052
Fax Number	:	419-354-2169

Provider Business Practice Location Address
First Line	:	1840 E GYPSY LANE RD
Second Line	:
City	:	BOWLING GREEN
State	:	OH
Zip	:	43402-9173
Country	:	US
Telephone Number	:	419-354-9052
Fax Number	:	419-354-2169

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	PAUL BOGNER
Credential	:	PHARMD
Telephone Number	:	419-354-9052

Provider Enumeration Date	:	06/17/2014
Last Update Date	:	06/17/2025

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