Provider Demographics
NPI:1700411535
Name:HRIC, WESLEY GIBBS (PHARMD)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:GIBBS
Last Name:HRIC
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 EBCO CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-7374
Mailing Address - Country:US
Mailing Address - Phone:800-552-6576
Mailing Address - Fax:800-277-7455
Practice Address - Street 1:30 EBCO CIR STE 102
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-7374
Practice Address - Country:US
Practice Address - Phone:800-552-6576
Practice Address - Fax:800-277-7455
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist