Provider Demographics
NPI:1306250410
Name:WOOD COUNTY COMMUNITY HEALTH AND WELLNESS CENTER PHARMACY
Entity type:Organization
Organization Name:WOOD COUNTY COMMUNITY HEALTH AND WELLNESS CENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:419-354-9052
Mailing Address - Street 1:1840 E GYPSY LANE RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-9173
Mailing Address - Country:US
Mailing Address - Phone:419-354-9052
Mailing Address - Fax:419-354-2169
Practice Address - Street 1:1840 E GYPSY LANE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-9173
Practice Address - Country:US
Practice Address - Phone:419-354-9052
Practice Address - Fax:419-354-2169
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOOD COUNTY AUDITOR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy