MEDICARE: MRS. HEATHER WILSON RPH, 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
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03129704	OH

General Provider Information

NPI Number	:	1770019671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER WILSON RPH, PHARMD

Provider Business Mailing Address
First Line	:	7345 STATE ROUTE 3
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-8654
Country	:	US
Telephone Number	:	614-794-5550
Fax Number	:

Provider Business Practice Location Address
First Line	:	7345 STATE ROUTE 3
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-8654
Country	:	US
Telephone Number	:	614-794-5550
Fax Number	:

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

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	06/09/2026

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