Provider Demographics
NPI:1497052641
Name:LEMON, KERRI LEA (RPH)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:LEA
Last Name:LEMON
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 1:4526 GAULEY TPKE
Mailing Address - Street 2:
Mailing Address - City:HEATERS
Mailing Address - State:WV
Mailing Address - Zip Code:26627-7002
Mailing Address - Country:US
Mailing Address - Phone:304-765-5324
Mailing Address - Fax:304-765-2575
Practice Address - Street 1:168 MAIN ST
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:WV
Practice Address - Zip Code:26601-1308
Practice Address - Country:US
Practice Address - Phone:304-765-2562
Practice Address - Fax:304-765-2575
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV5850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist