Individual
ED POSTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 SAINT THOMAS DR, WEIRTON, WV 26062-3831
(304) 723-5108
Mailing address
100 SAINT THOMAS DR, WEIRTON, WV 26062-3831
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03329131
OH
183500000X
Pharmacist
Primary
RP0007186
WV
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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