Provider Demographics
NPI:1811595804
Name:PRICE, EMILY JEAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JEAN
Last Name:PRICE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JEAN
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1005 STADIUM DR
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:WV
Mailing Address - Zip Code:26170-1229
Mailing Address - Country:US
Mailing Address - Phone:304-940-6236
Mailing Address - Fax:
Practice Address - Street 1:615 WELLS ST
Practice Address - Street 2:
Practice Address - City:SISTERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26175-1323
Practice Address - Country:US
Practice Address - Phone:304-652-6131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03439856183500000X
WVRP0012205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist