Keith Aloysius Wagner, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

33877 Issued in TX

Practice address

950 15TH St RM 1C-104C
Augusta, GA 30901-2608

Phone

(706) 733-0188

NPI assigned

Oct 22, 2018

Last updated

Oct 22, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1760958300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 WINDSOR CT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093477",
            "telephone_number": "706-833-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 15TH ST RM 1C-104C",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012608",
            "telephone_number": "706-733-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KEITH",
        "middle_name": "ALOYSIUS",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "33877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• W S Flanagin Jr Inc (Hill Drug Company)
• Miranda Wade
• Robert Tyson Wade, MS.
• Kristen Waghorn, MS, CCC-SLP
• Kathryn Ann Wagner, DPT
• Deborah P. Wakefield, LCSW
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1293)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1227)
• Wal-Mart Stores East LP (WalMart Pharmacy 10-4144)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4206)

• Pharmacist in Augusta, GA
• Providers in Augusta, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.

Verify at the official NPI Registry.