Provider Demographics
NPI:1902373020
Name:REMINGTON, WALDON I III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WALDON
Middle Name:I
Last Name:REMINGTON
Suffix:III
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 1:113 TINGLE RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-1434
Mailing Address - Country:US
Mailing Address - Phone:443-783-0233
Mailing Address - Fax:
Practice Address - Street 1:36729 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:DE
Practice Address - Zip Code:19967-6952
Practice Address - Country:US
Practice Address - Phone:302-539-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0005321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist