Provider Demographics
NPI:1649908252
Name:WPH LLC
Entity type:Organization
Organization Name:WPH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-718-8521
Mailing Address - Street 1:100 MCFARLAND RD
Mailing Address - Street 2:
Mailing Address - City:LOOKOUT MTN
Mailing Address - State:GA
Mailing Address - Zip Code:30750-3194
Mailing Address - Country:US
Mailing Address - Phone:423-718-8521
Mailing Address - Fax:
Practice Address - Street 1:100 MCFARLAND RD
Practice Address - Street 2:
Practice Address - City:LOOKOUT MTN
Practice Address - State:GA
Practice Address - Zip Code:30750-3194
Practice Address - Country:US
Practice Address - Phone:423-718-8521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy