Provider Demographics
NPI:1225376080
Name:EFFLAND, GERALD S JR
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:S
Last Name:EFFLAND
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 S QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-3316
Mailing Address - Country:US
Mailing Address - Phone:304-267-8903
Mailing Address - Fax:304-267-9175
Practice Address - Street 1:134 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-3316
Practice Address - Country:US
Practice Address - Phone:304-267-8903
Practice Address - Fax:304-267-9175
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0003754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist