Johnson, David Wayne
Johnson, David Wayne is an sole proprietor health care provider with primary practice located at 203 E Saint Paul St , Spring Valley IL 61362-2139. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Johnson, David Wayne can be contacted via phone (815) 664-5050.Contact Information
Primary practice address
203 E Saint Paul St
Spring Valley IL 61362-2139
Phone: (815) 664-5050
Fax: (815) 663-4069
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 051032176 | Illinois |
Profile Details
| NPI number | 1972676328 |
|---|---|
| LBN Legal business name | Johnson, David Wayne |
| Credentials | R.PH |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 15th, 2006 |
| Last updated | Mar 15th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972676328 | NPPES |
| Illinois | MEDICAID | 362982894001 |
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