MEDICARE: PATRICIA EDEN WINLAND R.PH.

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	RP0005973	WV

General Provider Information

NPI Number	:	1639489867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA EDEN WINLAND R.PH.

Provider Business Mailing Address
First Line	:	401 BUCKHANNON PIKE
Second Line	:
City	:	NUTTER FORT
State	:	WV
Zip	:	26301-4307
Country	:	US
Telephone Number	:	304-622-1204
Fax Number	:	304-623-4042

Provider Business Practice Location Address
First Line	:	401 BUCKHANNON PIKE
Second Line	:
City	:	NUTTER FORT
State	:	WV
Zip	:	26301-4307
Country	:	US
Telephone Number	:	304-622-1204
Fax Number	:	304-623-4042

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

Provider Enumeration Date	:	10/21/2010
Last Update Date	:	08/26/2014

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