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NPI Code Detail

MEDICARE: DR. JOHN WESLEY DICK PHARMD

MEDICARE: DR. JOHN WESLEY DICK PHARMD
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
1183500000XPharmacist018779KY

General Provider Information

NPI Number : 1538770227
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN WESLEY DICK PHARMD
Provider Business Mailing Address
First Line : 3700 FRANKFORT AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-2557
Country : US
Telephone Number : 502-899-9353
Fax Number : 502-899-9441
Provider Business Practice Location Address
First Line : 3700 FRANKFORT AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-2557
Country : US
Telephone Number : 502-899-9353
Fax Number : 502-899-9441
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2020
Last Update Date : 08/14/2020

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