Provider Demographics
NPI:1942345798
Name:OKEL, CHARLES EDWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:EDWARD
Last Name:OKEL
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 1:1 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:WV
Mailing Address - Zip Code:26033-1130
Mailing Address - Country:US
Mailing Address - Phone:304-686-2101
Mailing Address - Fax:
Practice Address - Street 1:1 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:WV
Practice Address - Zip Code:26033-1130
Practice Address - Country:US
Practice Address - Phone:304-686-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0003916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0139859000Medicaid