Active NPI
Logan Wagner, PHARMD
- Pharmacist
- Washington Court House, OH
National Provider Identifier
1235731019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03233013
- Practice address
- 1795 Columbus Ave
Washington Court House, OH 43160-1765 - Phone
- (740) 335-6162
- Fax
- (740) 335-1618
- NPI assigned
- Nov 16, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03233013 | OH | Primary |
Addresses
Primary practice location
1795 Columbus Ave
Washington Court House, OH 43160-1765
Mailing address
160 Butternut Pass
Commercial Point, OH 43116-9748
Phone (330) 687-7041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03233013 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1235731019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 BUTTERNUT PASS",
"city": "COMMERCIAL POINT",
"state": "OH",
"postal_code": "431169748",
"telephone_number": "330-687-7041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1795 COLUMBUS AVE",
"city": "WASHINGTON COURT HOUSE",
"state": "OH",
"postal_code": "431601765",
"telephone_number": "740-335-6162",
"fax_number": "740-335-1618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "LOGAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03233013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington Court House, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.