Provider Demographics
NPI:1699207423
Name:WILSEY, H ANDREW (PHARMD)
Entity type:Individual
Prefix:
First Name:H ANDREW
Middle Name:
Last Name:WILSEY
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 1:1 MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:367-168-5283
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:ROOM H110
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-323-4742
Practice Address - Fax:859-323-2049
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC302601835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program