MEDICARE: WESLEY PRICE

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	PS52385	FL

General Provider Information

NPI Number	:	1326444670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESLEY PRICE

Provider Business Mailing Address
First Line	:	1009 7TH AVE N # 1
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33705-1307
Country	:	US
Telephone Number	:	770-882-9489
Fax Number	:

Provider Business Practice Location Address
First Line	:	1009 7TH AVE N # 1
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33705-1307
Country	:	US
Telephone Number	:	770-882-9489
Fax Number	:

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

Provider Enumeration Date	:	11/14/2014
Last Update Date	:	11/14/2014

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Directions to “ WESLEY PRICE ” Practice Location

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