Provider Demographics
NPI:1235273103
Name:WERNIK, HAL ROBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:HAL
Middle Name:ROBERT
Last Name:WERNIK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 W SAN ANGELO ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-2923
Mailing Address - Country:US
Mailing Address - Phone:480-659-3365
Mailing Address - Fax:
Practice Address - Street 1:6202 S 16TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-4434
Practice Address - Country:US
Practice Address - Phone:602-268-0634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist