Individual
MARYLYN LANCASTER-KINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3040 UNIVERSITY AVE STE 1400, MORGANTOWN, WV 26505-3381
(304) 285-7216
Mailing address
7 RUCKERT RD, MORGANTOWN, WV 26508-2754
(304) 376-4224
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0006470
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP0006470
WV BOP ISSUED PHARMACY LICENSE
WV
Enumeration date
07/14/2022
Last updated
07/14/2022
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