Healthcare Provider Details

I. General information

NPI: 1427268184
Provider Name (Legal Business Name): JOHN IRVIN MOURAT RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 E 8TH ST
MARIETTA OH
45750-3383
US

IV. Provider business mailing address

62 SUNNYVIEW DR
WILLIAMSTOWN WV
26187-8375
US

V. Phone/Fax

Practice location:
  • Phone: 740-760-5850
  • Fax: 888-839-9491
Mailing address:
  • Phone: 304-375-1791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0005422
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-17873
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: