MEDICARE: MR. CONSTANTINE KWASI ASAMOAH RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP0007608	WV

General Provider Information

NPI Number	:	1952693269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CONSTANTINE KWASI ASAMOAH RPH

Provider Business Mailing Address
First Line	:	P.O.BOX 427
Second Line	:	200 VIRGINIA STREET
City	:	SMITHERS
State	:	WV
Zip	:	25186
Country	:	US
Telephone Number	:	304-442-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 VIRGINIA STREET
Second Line	:
City	:	SMITHERS
State	:	WV
Zip	:	25186-0000
Country	:	US
Telephone Number	:	304-442-7500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2011
Last Update Date	:	07/22/2014

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