Michael Brent Wilson, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

043025 Issued in PA

Practice address

171 W Crawford Ave
Connellsville, PA 15425-3526

Phone

(724) 626-1091

NPI assigned

Oct 15, 2006

Last updated

Mar 29, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238284800000",
    "number": "1356431647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 KAYLA CT",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154013992",
            "telephone_number": "724-434-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 W CRAWFORD AVE",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154253526",
            "telephone_number": "724-626-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2009-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "043025",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "5858",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Warwick
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• Richonda Williams
• Tyler Williams
• Wormack Caring Place Corp (WCPC)
• Wormack Inc.
• Raymond Daniel Wormack, LCSW
• Alex Yazhbin, M.D.

• Pharmacist in Connellsville, PA
• Providers in Connellsville, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2009; 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.