Provider Demographics
NPI:1518047422
Name:WYELS, JAMIE DALE (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:DALE
Last Name:WYELS
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 1:101 DENNIS DR
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-3003
Mailing Address - Country:US
Mailing Address - Phone:412-492-8080
Mailing Address - Fax:
Practice Address - Street 1:5850 MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9605
Practice Address - Country:US
Practice Address - Phone:724-444-5598
Practice Address - Fax:724-444-5585
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist