Provider Demographics
NPI:1215343405
Name:WOLF, WARNER HAMILTON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WARNER
Middle Name:HAMILTON
Last Name:WOLF
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-4418
Mailing Address - Country:US
Mailing Address - Phone:404-216-9295
Mailing Address - Fax:
Practice Address - Street 1:12405 BRANDON ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3589
Practice Address - Country:US
Practice Address - Phone:907-646-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program