Provider Demographics
NPI:1346645561
Name:WANSCHEK, JOHN IV (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:WANSCHEK
Suffix:IV
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:JACK
Other - Middle Name:
Other - Last Name:WANSCHEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1421 GULF SHORES PKWY
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-5909
Mailing Address - Country:US
Mailing Address - Phone:251-968-5946
Mailing Address - Fax:
Practice Address - Street 1:1421 GULF SHORES PKWY
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-5909
Practice Address - Country:US
Practice Address - Phone:251-968-5946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist