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General NPI Number Information
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NPI Number | 1235205758
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Entity Type | Individual
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Provider Name | MICHELE RENA DILLON
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Gender | Female
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 5170 US ROUTE 60 STE 2800
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City | HUNTINGTON
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State | WV
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Zip | 25705-2004
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Country | US
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Telephone | 304-399-3784
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Fax |
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Provider Business Mailing Address
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Address Line | 315 ROYAL BIRKDALE DR
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City | LAVALETTE
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State | WV
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Zip | 25535-9617
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Country | US
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Telephone | 304-654-2277
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP0006110
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 012671
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03126049
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License Number State | OH
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