Healthcare Provider Details

I. General information

NPI: 1851896815
Provider Name (Legal Business Name): SARAH REGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 03/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JOHN MARSHALL DR
HUNTINGTON WV
25755-0002
US

IV. Provider business mailing address

520 11TH AVE
HUNTINGTON WV
25701-3210
US

V. Phone/Fax

Practice location:
  • Phone: 304-696-7302
  • Fax:
Mailing address:
  • Phone: 304-654-6549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberIN0007964
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: