Active NPI
Samuel Rogers Wetherill IV, BS PHARMACY
- Pharmacist
- Wilmington, DE
National Provider Identifier
1801064779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2848
- Practice address
- 3931 Kirkwood Hwy
7221St Msu
Wilmington, DE 19808-5119 - Phone
- (410) 920-4494
- NPI assigned
- Feb 13, 2008
- 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 | 2848 | DE | Primary |
Addresses
Primary practice location
3931 Kirkwood Hwy
7221St Msu
Wilmington, DE 19808-5119
Mailing address
3931 Kirkwood Hwy
7221St Msu
Wilmington, DE 19808-5119
Phone (410) 920-4494
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NO NUMBER | Other | DE | MILITARY TRICARE |
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
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2848 | DE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202860800000",
"number": "1801064779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3931 KIRKWOOD HWY",
"address_2": "7221ST MSU",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198085119",
"telephone_number": "410-920-4494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3931 KIRKWOOD HWY",
"address_2": "7221ST MSU",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198085119",
"telephone_number": "410-920-4494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WETHERILL",
"first_name": "SAMUEL",
"middle_name": "ROGERS",
"name_prefix": "Mr.",
"name_suffix": "IV",
"credential": "BS PHARMACY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-13",
"last_updated": "2008-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DE",
"license": "2848",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MILITARY TRICARE",
"identifier": "NO NUMBER",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.