Garrison Scott Wagner, PharmD
Pharmacist in Benton, KY. Individual provider (NPI-1).
NPI number1982276366
StatusActive
Last updated in NPPESJul 14, 2021
Details
- NPI
- 1982276366
- Entity type
- Individual (NPI-1)
- Name
- Garrison Scott Wagner
- Credential
- PharmD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 14, 2021
- Certification date
- Jun 25, 2021
- Last updated
- Jul 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 022065 | KY | Yes |
Practice location
817 Main StBenton, KY 42025-1240
Phone 270-527-9374
Mailing address
817 Main StBenton, KY 42025-1240
Phone 127-052-7937
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