Healthcare Provider Details

I. General information

NPI: 1962468058
Provider Name (Legal Business Name): DOUGLAS E LESTER PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RT 10 COOK PARKWAY
OCEANA WV
24870-0699
US

IV. Provider business mailing address

RT 10 COOK PARKWAY
OCEANA WV
24870-0699
US

V. Phone/Fax

Practice location:
  • Phone: 304-682-8289
  • Fax: 304-682-4070
Mailing address:
  • Phone: 304-682-8289
  • Fax: 304-682-4070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0005835
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: