Provider Demographics
NPI:1558638643
Name:WHEELER, GERALD W (RPH)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:W
Last Name:WHEELER
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 1:1905 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-2537
Mailing Address - Country:US
Mailing Address - Phone:563-243-2247
Mailing Address - Fax:563-243-2331
Practice Address - Street 1:1905 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-2537
Practice Address - Country:US
Practice Address - Phone:563-243-2247
Practice Address - Fax:563-243-2331
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist