Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ivan Wesley Wisco

Individual provider Pharmacist · NPI 1164167318

Ivan Wesley Wisco is a Pharmacist in Charlottesville, Virginia. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2022
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Practice location Address checks out

1170 Emmet St N
Charlottesville, VA 22903-4836
Phone: (434) 293-9151
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 0202220011 (VA)

Record details

NPI number1164167318
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 2, 2022
Last updated in NPPESMay 2, 2022
Certification dateApril 5, 2022
Mailing address1170 Emmet St N, Charlottesville, VA 22903-4836

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