Provider Demographics
NPI:1386008522
Name:WALKER, CYNTHIA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:WALKER
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:PO BOX 2027
Mailing Address - Street 2:JARRELL'S PHARMACY
Mailing Address - City:SHADY SPRING
Mailing Address - State:WV
Mailing Address - Zip Code:25918-2027
Mailing Address - Country:US
Mailing Address - Phone:304-763-2442
Mailing Address - Fax:304-763-4230
Practice Address - Street 1:2122 RITTER DR
Practice Address - Street 2:JARRELL'S PHARMACY
Practice Address - City:DANIELS
Practice Address - State:WV
Practice Address - Zip Code:25832
Practice Address - Country:US
Practice Address - Phone:304-763-2442
Practice Address - Fax:304-763-4230
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV5694183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist