Provider Demographics
NPI:1982032108
Name:WARD, THERON (PHARM D)
Entity Type:Individual
Prefix:
First Name:THERON
Middle Name:
Last Name:WARD
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-1948
Mailing Address - Country:US
Mailing Address - Phone:866-248-1980
Mailing Address - Fax:
Practice Address - Street 1:210 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-1948
Practice Address - Country:US
Practice Address - Phone:866-248-1980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-25
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist