Provider Demographics
NPI:1780358523
Name:PAINTER, MARY ANN PATRICIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:PATRICIA
Last Name:PAINTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MARY ANN
Other - Middle Name:PATRICIA PAINTER
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6040 UNIVERSITY TOWN CENTRE DR.
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6040 UNIVERSITY TOWN CENTRE DR.
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501
Practice Address - Country:US
Practice Address - Phone:304-598-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP455844183500000X, 1835P2201X
OH03441250183500000X
WVRP0013145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care