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General NPI Number Information
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NPI Number | 1629611041
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Entity Type | Individual
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Provider Name | HAROLD WELLS
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Gender | Male
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Dates
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Enumeration Date | 10/18/2019
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Last Update Date | 10/18/2019
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Provider Practice Location Address
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Address Line | 3675 COAL HERITAGE RD
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City | BLUEFIELD
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State | WV
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Zip | 24701-9511
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Country | US
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Telephone | 304-589-7799
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Fax | 304-589-7759
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Provider Business Mailing Address
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Address Line | PO BOX 118
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City | BLUEFIELD
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State | WV
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Zip | 24701-0118
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Country | US
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Telephone | 304-589-7799
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Fax | 304-589-7759
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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 | RPH0004456
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License Number State | WV
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