Provider Demographics
NPI:1629386719
Name:HAMRIC, MARCELLA ELLEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARCELLA
Middle Name:ELLEN
Last Name:HAMRIC
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 1 BOX 187
Mailing Address - Street 2:PARRILL HOLLOW ROAD
Mailing Address - City:BURLINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26710-9622
Mailing Address - Country:US
Mailing Address - Phone:304-289-5255
Mailing Address - Fax:
Practice Address - Street 1:RR 3 BOX 3186
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-9415
Practice Address - Country:US
Practice Address - Phone:304-788-5931
Practice Address - Fax:304-788-9765
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist