Provider Demographics
NPI:1356489322
Name:WHEELER PHARMACY, LLC
Entity Type:Organization
Organization Name:WHEELER PHARMACY, LLC
Other - Org Name:THE DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:256-354-3784
Mailing Address - Street 1:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36251-0756
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:83871 HWY 9
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:AL
Practice Address - Zip Code:36251-0756
Practice Address - Country:US
Practice Address - Phone:256-354-3784
Practice Address - Fax:256-354-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1237360001Medicare NSC