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General NPI Number Information
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NPI Number | 1821621848
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Entity Type | Individual
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Provider Name | DAVID RYAN NOLAN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 4205 MACCORKLE AVE SE
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City | CHARLESTON
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State | WV
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Zip | 25304-2501
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Country | US
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Telephone | 304-925-0786
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Fax |
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Provider Business Mailing Address
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Address Line | 1928 PARKWOOD RD
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City | CHARLESTON
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State | WV
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Zip | 25314-2242
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Country | US
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Telephone | 304-545-9844
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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 | RP454134
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License Number State | PA
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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 | RP0010851
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License Number State | WV
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