Kevin G Wilson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP0006379 Issued in WV

Practice address

224 Howard Ave
Mullens, WV 25882-1421

Phone

(304) 294-5447

Fax

(304) 294-5714

NPI assigned

May 3, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Charlie's Pharmacy of Mullens, LLC

  • Long Term Care Pharmacy
  • Mullens, WV
  • NPI 1396623898
  NPD Authorized official
• Charlie's Pharmacy of Mullens, LLC

  • Community/Retail Pharmacy
  • Mullens, WV
  • NPI 1942499223
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1073258109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "MULLENS",
            "state": "WV",
            "postal_code": "258820788",
            "telephone_number": "304-294-5447",
            "fax_number": "304-294-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 HOWARD AVE",
            "city": "MULLENS",
            "state": "WV",
            "postal_code": "258821421",
            "telephone_number": "304-294-5447",
            "fax_number": "304-294-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KEVIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0006379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Wilfong
• Dwana Rae Wilkerson
• Julia Williams
• Francis Williamson
• Billie Wilson
• Octivia Wilson
• Jasmine Faith Wolford
• Judy Wolford
• Kimberly Wolford
• Danielle Nicole Wood

• Pharmacist in Mullens, WV
• Providers in Mullens, WV by specialty
• Pharmacist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.