Provider Demographics
NPI:1326168063
Name:POSTLETHWAIT, RENEE MARIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:MARIE
Last Name:POSTLETHWAIT
Suffix:
Gender:F
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:RR 4 BOX 517
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-9349
Mailing Address - Country:US
Mailing Address - Phone:304-598-4848
Mailing Address - Fax:304-598-4849
Practice Address - Street 1:1 STADIUM DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26507-0782
Practice Address - Country:US
Practice Address - Phone:304-598-4848
Practice Address - Fax:304-598-4849
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005238183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy