Provider Demographics
NPI:1962019752
Name:RIGGS, VICTORIA LOUISE
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LOUISE
Last Name:RIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 107
Mailing Address - Street 2:
Mailing Address - City:LORENTZ
Mailing Address - State:WV
Mailing Address - Zip Code:26229-0107
Mailing Address - Country:US
Mailing Address - Phone:304-472-7134
Mailing Address - Fax:
Practice Address - Street 1:250 COURT STREET
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452
Practice Address - Country:US
Practice Address - Phone:304-269-1125
Practice Address - Fax:304-269-6609
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-26
Last Update Date:2020-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV5244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist