Individual
AUTUMN NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506-1200
(304) 598-4148
(304) 598-4073
Mailing address
141 ASHLEY OAKS, MORGANTOWN, WV 26505-3678
(304) 668-3033
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0012688
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP0012688
PHARMACY LICENSE
WV
Enumeration date
07/11/2022
Last updated
07/11/2022
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