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Organization
WAGNER PHARMACY
Active
Organization
WAGNER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY R WAGNER RPH (PHARMACIST)
(309) 582-5678
Entity
Organization
Contact information
Practice address
108 N COLLEGE AVE, ALEDO, IL 61231-1519
(309) 582-5678
(309) 582-5679
Mailing address
108 N COLLEGE AVE, ALEDO, IL 61231-1519
(309) 582-5678
(309) 582-5679
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
IL
Other
Enumeration date
07/30/2006
Last updated
04/20/2008
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