Provider Demographics
NPI:1801194600
Name:ANDRIKO, LOUIS M (RPH)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:M
Last Name:ANDRIKO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3247
Mailing Address - Country:US
Mailing Address - Phone:304-636-8061
Mailing Address - Fax:
Practice Address - Street 1:150 MAIN ST
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:WV
Practice Address - Zip Code:26287-1213
Practice Address - Country:US
Practice Address - Phone:304-478-4864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0004313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist