Provider Demographics
NPI:1134154966
Name:HEAL, CHARLES E (RPH)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:E
Last Name:HEAL
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 1:190 OLD WHITE DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-1042
Mailing Address - Country:US
Mailing Address - Phone:304-647-5004
Mailing Address - Fax:
Practice Address - Street 1:347 GREENBRIER VALLEY MALL DRIVE
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901
Practice Address - Country:US
Practice Address - Phone:304-645-5169
Practice Address - Fax:847-396-3149
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005319183500000X
VA0202205688183500000X
PARP437602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist