Provider Demographics
NPI:1508092768
Name:HARPER, LETETIA MARIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:LETETIA
Middle Name:MARIE
Last Name:HARPER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILIPPI
Mailing Address - State:WV
Mailing Address - Zip Code:26416-1240
Mailing Address - Country:US
Mailing Address - Phone:304-457-4233
Mailing Address - Fax:304-457-6760
Practice Address - Street 1:303 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-1240
Practice Address - Country:US
Practice Address - Phone:304-457-4233
Practice Address - Fax:304-457-6760
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007152183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist