Provider Demographics
NPI:1003114331
Name:RADCLIFF, DON EDWARD (RPH)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:EDWARD
Last Name:RADCLIFF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 PINCH RD
Mailing Address - Street 2:
Mailing Address - City:ELKVIEW
Mailing Address - State:WV
Mailing Address - Zip Code:25071-9602
Mailing Address - Country:US
Mailing Address - Phone:304-935-4812
Mailing Address - Fax:304-935-4814
Practice Address - Street 1:242 N PINCH RD
Practice Address - Street 2:
Practice Address - City:ELKVIEW
Practice Address - State:WV
Practice Address - Zip Code:25071-9330
Practice Address - Country:US
Practice Address - Phone:304-935-4812
Practice Address - Fax:304-935-4814
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist