Provider Demographics
NPI:1942297619
Name:WARMAN'S PRESCRIPTION SERVICE
Entity Type:Organization
Organization Name:WARMAN'S PRESCRIPTION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:740-354-7979
Mailing Address - Street 1:1220 GAY ST
Mailing Address - Street 2:P.O. BOX 1111
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-3460
Mailing Address - Country:US
Mailing Address - Phone:740-354-7979
Mailing Address - Fax:
Practice Address - Street 1:1220 GAY ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3460
Practice Address - Country:US
Practice Address - Phone:740-354-7979
Practice Address - Fax:740-354-2238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0626513Medicaid
OH0626513Medicaid