Provider Demographics
NPI:1285647909
Name:WHEELER, GREGORY WADE (RPH)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:WADE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 WEST FRONT STREET
Mailing Address - Street 2:SUITE 1850
Mailing Address - City:RICHANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-0000
Mailing Address - Country:US
Mailing Address - Phone:276-596-6600
Mailing Address - Fax:276-596-6626
Practice Address - Street 1:2951 FRONT ST
Practice Address - Street 2:SUITE 1850
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-2055
Practice Address - Country:US
Practice Address - Phone:276-596-6600
Practice Address - Fax:276-596-6626
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist