Provider Demographics
NPI:1144767328
Name:SCHWARTZ, HEATHER A (PHARMD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:WV
Mailing Address - Zip Code:25265-0528
Mailing Address - Country:US
Mailing Address - Phone:304-812-3625
Mailing Address - Fax:
Practice Address - Street 1:635 MAIN ST W
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-1107
Practice Address - Country:US
Practice Address - Phone:304-372-7448
Practice Address - Fax:304-372-8619
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0011713183500000X
KYI12396390200000X
OH6014250390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program