Healthcare Provider Details

I. General information

NPI: 1861790115
Provider Name (Legal Business Name): MS. LOUISE A PAPCIAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ROOSEVELT BLVD ROOSEVELT BOULEVARD
ELEANOR WV
25070-4000
US

IV. Provider business mailing address

3619 BROOKSHIRE DR
HURRICANE WV
25526-9415
US

V. Phone/Fax

Practice location:
  • Phone: 304-586-9064
  • Fax:
Mailing address:
  • Phone: 304-397-6161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4124
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: