NPIMap

Organization Active NPI

Wightman Pharmacy Inc

  • Community/Retail Pharmacy
  • Waterloo, IL
National Provider Identifier
1831116763
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054001471 Issued in IL
Legal business name
WIGHTMAN PHARMACY INC
Doing business as
WIGHTMAN PHARMACY
Practice address
127 S Main St
Waterloo, IL 62298-1371
Phone
(618) 939-6218
Fax
(618) 939-4633
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Authorized official

Name
Steve Wightman, RPHNPI 1558381590
Title
Owner/Pharm
Phone
(618) 939-6218

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054001471 IL Primary

Addresses

Primary practice location

127 S Main St
Waterloo, IL 62298-1371

Mailing address

127 S Main St
Waterloo, IL 62298-1371
Phone (618) 939-6218

Other identifiers 1

IdentifierTypeStateIssuer
2016696OtherPK

Other names 1

  • WIGHTMAN PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

127 S Main St
Waterloo, IL 62298
Phone (618) 939-6218

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1831116763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S MAIN ST",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981371",
            "telephone_number": "618-939-6218",
            "fax_number": "618-939-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S MAIN ST",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981371",
            "telephone_number": "618-939-6218",
            "fax_number": "618-939-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIGHTMAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "WIGHTMAN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OWNER/PHARM",
        "authorized_official_telephone_number": "618-939-6218",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054001471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2016696",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WIGHTMAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterloo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.