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General NPI Number Information
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NPI Number | 1881706299
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Entity Type | Individual
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Provider Name | ADELE MARIE STORM RPH
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 115 LAFAYETTE AVE
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City | MOUNDSVILLE
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State | WV
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Zip | 26041-1028
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Country | US
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Telephone | 304-845-0390
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Fax | 304-845-0391
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Provider Business Mailing Address
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Address Line | 406 HAZLETT AVE
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City | WHEELING
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State | WV
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Zip | 26003-6925
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Country | US
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Telephone | 304-277-4654
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Fax | 304-845-0391
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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 | 4618
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License Number State | WV
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