Provider Demographics
NPI:1821445305
Name:WARNICK, NATHANIEL JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:JAMES
Last Name:WARNICK
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 1:3175 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-4830
Mailing Address - Country:US
Mailing Address - Phone:812-339-7730
Mailing Address - Fax:
Practice Address - Street 1:3175 W 3RD ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-4830
Practice Address - Country:US
Practice Address - Phone:812-339-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26024677A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist