Provider Demographics
NPI:1851684021
Name:MAKRICOSTAS, EUGENIA NIKKI (RPH)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:NIKKI
Last Name:MAKRICOSTAS
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 1:434 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-5090
Mailing Address - Country:US
Mailing Address - Phone:304-723-3681
Mailing Address - Fax:
Practice Address - Street 1:1360 COVE RD
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-4205
Practice Address - Country:US
Practice Address - Phone:304-723-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-22
Last Update Date:2011-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist