Provider Demographics
NPI:1679844138
Name:KNIGHT, PEGGY ANN (RPH)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:ANN
Last Name:KNIGHT
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 1:2991 STATE ROUTE 160
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-8441
Mailing Address - Country:US
Mailing Address - Phone:740-446-6620
Mailing Address - Fax:740-446-7849
Practice Address - Street 1:2991 STATE ROUTE 160
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-8441
Practice Address - Country:US
Practice Address - Phone:740-446-6620
Practice Address - Fax:740-446-7849
Is Sole Proprietor?:No
Enumeration Date:2012-01-14
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03216678183500000X
WVRP0004231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist