Provider Demographics
NPI:1932491214
Name:MYERS, JAY WESLEY (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:WESLEY
Last Name:MYERS
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 1:205 MARSHALL ST N
Mailing Address - Street 2:
Mailing Address - City:BENWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26031-1024
Mailing Address - Country:US
Mailing Address - Phone:304-232-6103
Mailing Address - Fax:
Practice Address - Street 1:205 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:BENWOOD
Practice Address - State:WV
Practice Address - Zip Code:26031
Practice Address - Country:US
Practice Address - Phone:304-232-6103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3284183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist