MEDICARE: DR. ASHLEY WALTMAN PHARM D

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	RP442752	PA

General Provider Information

NPI Number	:	1942804026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY WALTMAN PHARM D

Provider Business Mailing Address
First Line	:	615 LOCUST ST
Second Line	:
City	:	COLUMBIA
State	:	PA
Zip	:	17512-1226
Country	:	US
Telephone Number	:	717-684-6361
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 LOCUST ST
Second Line	:
City	:	COLUMBIA
State	:	PA
Zip	:	17512-1226
Country	:	US
Telephone Number	:	717-684-6361
Fax Number	:

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

Provider Enumeration Date	:	11/30/2020
Last Update Date	:	11/30/2020

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