Samuel L Waddell II, RPH
Individual provider Active NPI Pharmacist · Sitka, KY
NPI 1083756019 · NPPES record last updated Mar 21, 2017
Key facts
- NPI
- 1083756019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 011108 (KY)
- Practice address
- 377 Meade BR
Sitka, KY 41255-9335 - Phone
- (606) 369-6356
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011108 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sam Waddell Consulting Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 011108 | KY | Yes |
| Geriatric Pharmacist | 1835G0303X | 011108 | KY |
Addresses
Primary practice location
377 Meade BR
Sitka, KY 41255-9335
Mailing address
377 Meade BR
Sitka, KY 41255-9335
Phone (606) 369-6356
Other providers in Sitka, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.