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General NPI Number Information
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NPI Number | 1619100781
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Entity Type | Individual
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Provider Name | HEIDI N HAINES PHARM D
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Gender | Female
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Dates
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Enumeration Date | 08/24/2009
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Last Update Date | 08/24/2009
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Provider Practice Location Address
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Address Line | 7916 WINCHESTER AVE
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City | INWOOD
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State | WV
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Zip | 25428-4066
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Country | US
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Telephone | 304-229-0935
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Fax | 304-229-5790
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Provider Business Mailing Address
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Address Line | 21 DOYLE ST
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City | GERRARDSTOWN
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State | WV
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Zip | 25420-4525
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Country | US
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Telephone | 304-229-5454
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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 | RP0007161
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License Number State | WV
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