MEDICARE: DR. JONATHAN RYAN WOODS PHARMD., 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	0202206569	VA

General Provider Information

NPI Number	:	1306974456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN RYAN WOODS PHARMD., RPH.

Provider Business Mailing Address
First Line	:	PO BOX 458
Second Line	:
City	:	ROSEDALE
State	:	VA
Zip	:	24280-0458
Country	:	US
Telephone Number	:	276-880-9295
Fax Number	:

Provider Business Practice Location Address
First Line	:	RR 5 BOX 20
Second Line	:
City	:	GRUNDY
State	:	VA
Zip	:	24614-9611
Country	:	US
Telephone Number	:	276-935-8718
Fax Number	:

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	07/08/2007

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