| Mr Steven Lyle Wagner, | |
|
1833 Kingshighway, Washington Park, IL 62204 | |
| (618) 874-3000 | |
| (618) 674-3103 |
| Full Name | Mr Steven Lyle Wagner |
|---|---|
| Gender | Male |
| Speciality | Pharmacist |
| Location | 1833 Kingshighway, Washington Park, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679460778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 183500000X | Pharmacist | 051031829 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Steven Lyle Wagner, 1833 Kingshighway, East Saint Louis, IL 62204-2135 Ph: (618) 874-3000 | Mr Steven Lyle Wagner, 1833 Kingshighway, Washington Park, IL 62204 Ph: (618) 874-3000 |
Terry Michael Maddox, PHARM D Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 1833 Kingshighway, Suite 200, Washington Park, IL 62204 Phone: 618-874-3000 Fax: 618-874-3019 | |
Mr. Michael Lee Schaltenbrand, R.PH. Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 1833 Kingshighway, Suite 100, Washington Park, IL 62204 Phone: 618-874-3000 Fax: 318-874-3019 |