Provider Demographics
NPI:1952693269
Name:ASAMOAH, CONSTANTINE KWASI (RPH)
Entity type:Individual
Prefix:MR
First Name:CONSTANTINE
Middle Name:KWASI
Last Name:ASAMOAH
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:P.O.BOX 427
Mailing Address - Street 2:200 VIRGINIA STREET
Mailing Address - City:SMITHERS
Mailing Address - State:WV
Mailing Address - Zip Code:25186
Mailing Address - Country:US
Mailing Address - Phone:304-442-7500
Mailing Address - Fax:
Practice Address - Street 1:200 VIRGINIA STREET
Practice Address - Street 2:
Practice Address - City:SMITHERS
Practice Address - State:WV
Practice Address - Zip Code:25186-0000
Practice Address - Country:US
Practice Address - Phone:304-442-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist