Provider Demographics
NPI:1619258720
Name:WEILAND, ANTHONY W (PHARMD RPH)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:W
Last Name:WEILAND
Suffix:
Gender:M
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4370 HOBNAIL CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45432-1859
Mailing Address - Country:US
Mailing Address - Phone:716-807-9399
Mailing Address - Fax:
Practice Address - Street 1:4370 HOBNAIL CT
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-1859
Practice Address - Country:US
Practice Address - Phone:716-807-9399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03330925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist