Provider Demographics
NPI:1689959447
Name:WILKINSON, WARREN LEON II (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:LEON
Last Name:WILKINSON
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 COMMONWEALTH BLVD W
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-1800
Mailing Address - Country:US
Mailing Address - Phone:276-666-1720
Mailing Address - Fax:276-666-1814
Practice Address - Street 1:240 WEST COMMONWEALTH BLVD.
Practice Address - Street 2:KROGER PHARMACY
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112
Practice Address - Country:US
Practice Address - Phone:276-666-1720
Practice Address - Fax:276-666-1814
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206190183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist