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General NPI Number Information
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NPI Number | 1578796801
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Entity Type | Individual
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Provider Name | BRAD WARREN HATCHER RPH
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Gender | Male
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 6401 SISSONVILLE DR
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City | CHARLESTON
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State | WV
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Zip | 25312-9463
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Country | US
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Telephone | 304-984-9597
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Fax |
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Provider Business Mailing Address
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Address Line | 110 ELIZABETH ST
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City | CHARLESTON
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State | WV
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Zip | 25311-2117
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Country | US
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Telephone | 304-389-0343
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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 | RPH0005372
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License Number State | WV
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