Provider Demographics
NPI:1578182325
Name:BELCHER, MACKENZIE ALEXANDRIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:ALEXANDRIA
Last Name:BELCHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48450 SLOANS RUN RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8611
Mailing Address - Country:US
Mailing Address - Phone:740-491-4888
Mailing Address - Fax:
Practice Address - Street 1:1300 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:MOUNDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26041-2317
Practice Address - Country:US
Practice Address - Phone:304-845-8298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0011869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist