MEDICARE: DR. JUSTIN WESLEY COLE PHARMD, BCPS

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	03127301	OH

General Provider Information

NPI Number	:	1417284159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN WESLEY COLE PHARMD, BCPS

Provider Business Mailing Address
First Line	:	251 N MAIN ST
Second Line	:
City	:	CEDARVILLE
State	:	OH
Zip	:	45314-8501
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1207 DELAWARE AVE
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19806-4743
Country	:	US
Telephone Number	:	888-736-0073
Fax Number	:

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

Provider Enumeration Date	:	11/17/2009
Last Update Date	:	01/05/2026

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