Healthcare Provider Details

I. General information

NPI: 1285843193
Provider Name (Legal Business Name): JOEL P FISHER R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3504 WINFIELD RD
WINFIELD WV
25213
US

IV. Provider business mailing address

117 WATERSIDE CIR
WINFIELD WV
25213-9551
US

V. Phone/Fax

Practice location:
  • Phone: 304-586-3088
  • Fax: 304-204-2086
Mailing address:
  • Phone: 304-586-3393
  • Fax: 304-204-2086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5826
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: