Provider Demographics
NPI:1760478648
Name:WARREN, JOHN ALBERT (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ALBERT
Last Name:WARREN
Suffix:
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 1:16420 CARMEL LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-5712
Mailing Address - Country:US
Mailing Address - Phone:775-849-2826
Mailing Address - Fax:
Practice Address - Street 1:16420 CARMEL LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-5712
Practice Address - Country:US
Practice Address - Phone:775-849-2826
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV84761835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric