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General NPI Number Information
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NPI Number | 1679987655
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Entity Type | Organization
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Legal Business Name | HIGHLAND BEHAVIORAL HEALTH SERVICES, INC
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Dates
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Enumeration Date | 06/17/2014
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 2500 CHEROKEE AVENUE
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City | CHARLESTON
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State | WV
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Zip | 25304
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Country | US
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Telephone | 304-348-2416
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4009
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City | CHARLESTON
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State | WV
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Zip | 25364-4009
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | DAN WALKER
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Credential | RPH
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Telephone | 304-348-2416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 23020177
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License Number State | WV
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