Provider Demographics
NPI:1710308549
Name:WINQUIST, WILLIAM A (RPH,PHARMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:WINQUIST
Suffix:
Gender:M
Credentials:RPH,PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9507 MARSENA CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-3760
Mailing Address - Country:US
Mailing Address - Phone:704-962-2487
Mailing Address - Fax:
Practice Address - Street 1:9507 MARSENA CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-3760
Practice Address - Country:US
Practice Address - Phone:704-962-2487
Practice Address - Fax:980-819-7374
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist