Individual
CHARLES DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
201 ROOSEVELT BLVD, ELEANOR, WV 25070
(304) 586-9064
Mailing address
201 ROOSEVELT BLVD, ELEANOR, WV 25070
(304) 586-9064
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0012857
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP0012857
WEST VIRGINIA BOARD OF PHARMACY
WV
Enumeration date
01/11/2022
Last updated
01/11/2022
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