Wiesley, Russell Duane
Wiesley, Russell Duane is an individual health care provider with primary practice located at 4343 Merle Hay Rd , Des Moines IA 50310-1411. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Wiesley, Russell Duane can be contacted via phone (515) 276-4845.Contact Information
Primary practice address
4343 Merle Hay Rd
Des Moines IA 50310-1411
Phone: (515) 276-4845
Fax: (515) 331-3163
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 14611 | Iowa |
Profile Details
| NPI number | 1295738102 |
|---|---|
| LBN Legal business name | Wiesley, Russell Duane |
| Credentials | RPH, CDM |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2005 |
| Last updated | Sep 18th, 2008 - about 17 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 | 1295738102 | NPPES |
| Iowa | MEDICAID | 0007559 |
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