Provider Demographics
NPI:1376824326
Name:CALDWELL, WESLEY HAYES (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:HAYES
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 ASHWOOD CIR NE
Mailing Address - Street 2:APARTMENT 202
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-6395
Mailing Address - Country:US
Mailing Address - Phone:276-698-9933
Mailing Address - Fax:
Practice Address - Street 1:3970 VALLEY GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-6773
Practice Address - Country:US
Practice Address - Phone:540-977-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-05
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist