Healthcare Provider Details

I. General information

NPI: 1619410537
Provider Name (Legal Business Name): ABIGAIL HURLOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2016
Last Update Date: 11/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 JACKSON AVE
POINT PLEASANT WV
25550-2035
US

IV. Provider business mailing address

2501 JACKSON AVE
POINT PLEASANT WV
25550-2035
US

V. Phone/Fax

Practice location:
  • Phone: 304-675-2303
  • Fax: 304-675-7762
Mailing address:
  • Phone: 304-675-2303
  • Fax: 304-675-7762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number0012150
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: