SIMON B. VAN WAGENEN RPH – NPI #1790816072
Pharmacist

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

SIMON VAN WAGENEN is a pharmacist located in STARKE, FL. NPPES has assigned the NPI number 1790816072 to SIMON VAN WAGENEN on March 08, 2007. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 183500000X from the Health Care Provider Taxonomy code set, which is classified as Pharmacist.

The NPI profile was previously updated about 19 years ago on Jul 09, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SIMON VAN WAGENEN below.

NPI Profile for
SIMON B. VAN WAGENEN

NPI Number
1790816072
Enumeration Date

(more than 19 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
SIMON B. VAN WAGENEN
Credentials
RPH
Primary location
470 W MADISON ST
STARKE, FL 32091-3926
Phone: (904) 964-6759 Fax: (904) 964-5315
Mailing address
15604 SW 161ST ST
BROOKER, FL 32622-2540
Phone: (904) 449-3937 Fax: (904) 964-5315
Sole Proprietor
No
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
183500000X
- Pharmacist (Primary)
FL PS16532

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.