Active NPI
Michael Allen Wagoner, RPH
- Pharmacist
- Franklin, WV
National Provider Identifier
1760781678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0005143
- Practice address
- 71 Mountaineer Dr
HC 71 Box 1F
Franklin, WV 26807 - Phone
- (304) 358-3272
- Fax
- (304) 358-3279
- NPI assigned
- Mar 17, 2011
- 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 | RP0005143 | WV | Primary |
Addresses
Primary practice location
71 Mountaineer Dr
HC 71 Box 1F
Franklin, WV 26807
Mailing address
71 Mountaineer Dr
HC 71 Box 1F
Franklin, WV 26807
Phone (304) 358-2475
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP0005143 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301011200000",
"number": "1760781678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 MOUNTAINEER DR",
"address_2": "HC 71 BOX 1F",
"city": "FRANKLIN",
"state": "WV",
"postal_code": "26807",
"telephone_number": "304-358-2475",
"fax_number": "304-358-3279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 MOUNTAINEER DR",
"address_2": "HC 71 BOX 1F",
"city": "FRANKLIN",
"state": "WV",
"postal_code": "26807",
"telephone_number": "304-358-3272",
"fax_number": "304-358-3279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGONER",
"first_name": "MICHAEL",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-17",
"last_updated": "2011-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0005143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Franklin, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.