Healthcare Provider Details

I. General information

NPI: 1124315015
Provider Name (Legal Business Name): JOSEPH HOVIOUS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 THUNDERING HERD DR T-1478
BARBOURSVILLE WV
25504-2600
US

IV. Provider business mailing address

2070 THUNDERING HERD DR T-1478
BARBOURSVILLE WV
25504-2600
US

V. Phone/Fax

Practice location:
  • Phone: 304-736-7651
  • Fax: 304-736-7651
Mailing address:
  • Phone: 304-736-7651
  • Fax: 304-736-7651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0004891
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: