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NPI Code Detail

MEDICARE: STEPHEN ANTHONY WICHER RPH

MEDICARE: STEPHEN ANTHONY WICHER 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
1183500000XPharmacist11060NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111060OTHERNCNC PHARMACY LICENSE

General Provider Information

NPI Number : 1437466257
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN ANTHONY WICHER RPH
Provider Business Mailing Address
First Line : 3404 WYNESTON RD
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-6544
Country : US
Telephone Number : 252-321-0222
Fax Number : 252-321-0508
Provider Business Practice Location Address
First Line : 1872 W ARLINGTON BLVD
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-5704
Country : US
Telephone Number : 252-321-0222
Fax Number : 252-321-0508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2010
Last Update Date : 09/01/2010

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