Provider Demographics
NPI:1780323287
Name:MORGAN, JOHN DAVID (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:MORGAN
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 1:307 5TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:WV
Mailing Address - Zip Code:25265-4100
Mailing Address - Country:US
Mailing Address - Phone:304-882-2005
Mailing Address - Fax:
Practice Address - Street 1:307 5TH ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:WV
Practice Address - Zip Code:25265-4100
Practice Address - Country:US
Practice Address - Phone:304-882-2005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0003416183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist