Individual
SAMUEL RANDOLPH BALLENGEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
54 W 2ND AVE, WILLIAMSON, WV 25661-3506
(304) 475-0080
(304) 475-0080
Mailing address
PO BOX 538, WILLIAMSON, WV 25661-0538
(304) 475-0080
(304) 475-0080
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0006318
WV
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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