Johnna Shay Harter
Individual provider Active NPI Pharmacist · Mannington, WV
NPI 1013511617 · NPPES record last updated Nov 24, 2020
Key facts
- NPI
- 1013511617
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0005775 (WV)
- Practice address
- 720 E Main St
Mannington, WV 26582-1259 - Phone
- (304) 815-2165
- NPI assigned
- Nov 24, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0005775 | WV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mannington Pharmacy | Current |
Accepting new patients | |
| Mannington Pharmacy | Current |
Accepting new patients |
Locations
720 E Main St
Mannington, WV 26582
Phone (304) 815-2165
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0005775 | WV | Yes |
Addresses
Primary practice location
720 E Main St
Mannington, WV 26582-1259
Mailing address
8592 N Fork Rd
Pine Grove, WV 26419-8361
Phone (304) 815-2165
Other providers in Mannington, WV
- Brittany Greathouse
- Michele Gump
- Courtney Hamrick
- Laura Ann Harris
- Amanda Hart
- James Hewitt Jr.
- Larry Hickman
- George B Higgs
- Leann Hostuttler
- Brittany Isner
All providers in Mannington, WV · Pharmacist in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.