Provider Demographics
NPI:1831228733
Name:MEALEY, CHRISTOPHER KYLE (RPH)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:KYLE
Last Name:MEALEY
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 1:906 MIDDLE FORK ROAD
Mailing Address - Street 2:
Mailing Address - City:REEDY
Mailing Address - State:WV
Mailing Address - Zip Code:25270
Mailing Address - Country:US
Mailing Address - Phone:304-927-0022
Mailing Address - Fax:304-927-6334
Practice Address - Street 1:200 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:WV
Practice Address - Zip Code:25276
Practice Address - Country:US
Practice Address - Phone:304-927-6252
Practice Address - Fax:304-927-6334
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2015-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist