Provider Demographics
NPI:1619403441
Name:STARCHER, ALYSSA (RPH)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:STARCHER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LAKEVIEW DR STE G
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-4414
Mailing Address - Country:US
Mailing Address - Phone:304-755-8460
Mailing Address - Fax:
Practice Address - Street 1:125 LAKEVIEW DR STE G
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-4414
Practice Address - Country:US
Practice Address - Phone:304-755-8460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV60611835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric