Provider Demographics
NPI:1851723829
Name:HARVEY, RYAN ANDREW (PHARMD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:ANDREW
Last Name:HARVEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WV
Mailing Address - Zip Code:25541-1220
Mailing Address - Country:US
Mailing Address - Phone:304-743-7912
Mailing Address - Fax:304-743-8121
Practice Address - Street 1:1010 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WV
Practice Address - Zip Code:25541-1220
Practice Address - Country:US
Practice Address - Phone:304-743-7912
Practice Address - Fax:304-743-8121
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist