MEDICARE: MRS. AIMEE BETH HELMICK RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202012895	VA
2	183500000X	Pharmacist	RP0006949	WV

General Provider Information

NPI Number	:	1578015756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AIMEE BETH HELMICK RPH

Provider Business Mailing Address
First Line	:	111 S GROVE ST
Second Line	:
City	:	PETERSBURG
State	:	WV
Zip	:	26847-1804
Country	:	US
Telephone Number	:	304-530-6301
Fax Number	:	304-530-6303

Provider Business Practice Location Address
First Line	:	111 S GROVE ST
Second Line	:
City	:	PETERSBURG
State	:	WV
Zip	:	26847-1804
Country	:	US
Telephone Number	:	304-530-6301
Fax Number	:	304-530-6303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2016
Last Update Date	:	02/20/2020

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