Active NPI
Eric Wolfgang
- Pharmacist
- Du Bois, PA
National Provider Identifier
1245748151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP441124
- Practice address
- 621 S Main St
Du Bois, PA 15801-1413 - Phone
- (814) 375-6165
- NPI assigned
- Jan 12, 2018
- 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 | RP441124 | PA | Primary |
Addresses
Primary practice location
621 S Main St
Du Bois, PA 15801-1413
Mailing address
621 S Main St
Du Bois, PA 15801-1413
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP441124 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515715200000",
"number": "1245748151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 S MAIN ST",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158011413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 S MAIN ST",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158011413",
"telephone_number": "814-375-6165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFGANG",
"first_name": "ERIC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-12",
"last_updated": "2018-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP441124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Du Bois, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.