MEDICARE: MRS. JOAN RUTH WISSINGER 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
1	183500000X	Pharmacist	03-3-22178	OH

General Provider Information

NPI Number	:	1871710053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOAN RUTH WISSINGER RPH

Provider Business Mailing Address
First Line	:	226 PLAYERS CLUB CT
Second Line	:
City	:	COMMERCIAL POINT
State	:	OH
Zip	:	43116-9700
Country	:	US
Telephone Number	:	740-983-4340
Fax Number	:

Provider Business Practice Location Address
First Line	:	131 N HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-3018
Country	:	US
Telephone Number	:	614-228-4476
Fax Number	:	614-228-4479

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/08/2007

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