Individual
PHIL SAMPLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
204 TOWN CENTER RD, FAYETTEVILLE, WV 25840-9540
(304) 575-5472
(304) 574-1283
Mailing address
204 TOWN CENTER RD, FAYETTEVILLE, WV 25840-9540
(304) 575-5472
(304) 574-1283
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0004158
WV
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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