Provider Demographics
NPI:1932964418
Name:PRESCOTT, WAYNE ERIC (PHARMD)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:ERIC
Last Name:PRESCOTT
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 1:813 LOWER MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAXTON
Mailing Address - State:PA
Mailing Address - Zip Code:16678-1139
Mailing Address - Country:US
Mailing Address - Phone:814-635-2911
Mailing Address - Fax:814-635-3490
Practice Address - Street 1:813 LOWER MAIN ST
Practice Address - Street 2:
Practice Address - City:SAXTON
Practice Address - State:PA
Practice Address - Zip Code:16678-1139
Practice Address - Country:US
Practice Address - Phone:814-635-2911
Practice Address - Fax:814-635-3490
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034390R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist