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Individual

SIDDARTHAN ILANGOVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.PHARM., R.PH.

Contact information

Practice address
360 MOUNT GAY RD, BYPASS PHARMACY # 6, MOUNT GAY, WV 25637
(304) 752-1445
Mailing address
150 SAINT CLAIR LN, BECKLEY, WV 25801-7900
(304) 222-3064

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH00050913
WA
183500000X
Pharmacist
Primary
RP0006641
WV

Other

Enumeration date
09/20/2019
Last updated
09/20/2019
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