Individual
MICHELE WASMUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4507 SEQUOIA DR APT B206, HARRISBURG, PA 17109-6404
(814) 363-1098
Mailing address
4207 SEQUOIA DRIVE, APARTMENT 206B, HARRISBURG, PA 17109
(814) 363-1098
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36236591
OHIO
OH
01
—
43418
PHARMACY
CA
01
—
RP453120
PHARMACY
PA
Enumeration date
05/27/2022
Last updated
05/27/2022
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