Provider Demographics
NPI:1639489867
Name:WINLAND, PATRICIA EDEN (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:EDEN
Last Name:WINLAND
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 1:401 BUCKHANNON PIKE
Mailing Address - Street 2:
Mailing Address - City:NUTTER FORT
Mailing Address - State:WV
Mailing Address - Zip Code:26301-4307
Mailing Address - Country:US
Mailing Address - Phone:304-622-1204
Mailing Address - Fax:304-623-4042
Practice Address - Street 1:401 BUCKHANNON PIKE
Practice Address - Street 2:
Practice Address - City:NUTTER FORT
Practice Address - State:WV
Practice Address - Zip Code:26301-4307
Practice Address - Country:US
Practice Address - Phone:304-622-1204
Practice Address - Fax:304-623-4042
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVRP0005973OtherWV LICENSE #