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NPI 1306293121

NPI 1306293121 : DENISE ELIZABETH CANBY RPH : MARTINSBURG, WV

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General NPI Number Information
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    NPI Number           |    1306293121
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    Entity Type          |    Individual 
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    Provider Name        |    DENISE ELIZABETH CANBY RPH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/22/2016
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    Last Update Date     |    05/22/2016
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Provider Practice Location Address
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    Address Line         |    510 BUTLER AVE 
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    City                 |    MARTINSBURG
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    State                |    WV
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    Zip                  |    25405-9990
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    Country              |    US
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    Telephone            |    800-817-3807
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    Fax                  |    304-262-4888
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Provider Business Mailing Address
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    Address Line         |    510 BUTLER AVE 
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    City                 |    MARTINSBURG
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    State                |    WV
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    Zip                  |    25405-9990
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    Country              |    US
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    Telephone            |    304-263-0811
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    Fax                  |    304-262-4888
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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       |    0202211373
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    License Number State |    VA
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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       |    PH18952
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    License Number State |    MA
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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       |    RPH39372
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    License Number State |    CA
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