Provider Demographics
NPI:1457846552
Name:WOODWARD, JOHN HOWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HOWARD
Last Name:WOODWARD
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 1:3144 CR 5800
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-7956
Mailing Address - Country:US
Mailing Address - Phone:620-330-2163
Mailing Address - Fax:
Practice Address - Street 1:121 PETER PAN RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-7307
Practice Address - Country:US
Practice Address - Phone:620-330-2163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-30
Last Update Date:2018-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist