Healthcare Provider Details

I. General information

NPI: 1447166335
Provider Name (Legal Business Name): SURA NASER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1538 CHARLESTON AVE
HUNTINGTON WV
25701
US

IV. Provider business mailing address

39 COACH PL
HURRICANE WV
25526-5857
US

V. Phone/Fax

Practice location:
  • Phone: 304-696-7302
  • Fax:
Mailing address:
  • Phone: 304-767-0025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberIN0010387
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: