Elisha E Wentz, PHARMD
Individual provider Active NPI Pharmacist · Marion, VA
NPI 1295069565 · NPPES record last updated Sep 19, 2009
Key facts
- NPI
- 1295069565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202208586 (VA)
- Practice address
- 795 N Main St
Marion, VA 24354-3403 - Phone
- (276) 783-4115
- Fax
- (276) 783-1411
- NPI assigned
- Sep 19, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202208586 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202208586 | VA | Yes |
Addresses
Primary practice location
795 N Main St
Marion, VA 24354-3403
Mailing address
795 N Main St
Marion, VA 24354-3403
Phone (276) 783-4115
Other providers in Marion, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2009. 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.