Provider Demographics
NPI:1871995332
Name:WARD, MARY MARGARET (RPH)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:WARD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:M
Other - Middle Name:MARGARET
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:1793 BURNT ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-8381
Mailing Address - Country:US
Mailing Address - Phone:805-237-2673
Mailing Address - Fax:
Practice Address - Street 1:180 NIBLICK RD
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-4842
Practice Address - Country:US
Practice Address - Phone:805-238-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist