Provider Demographics
NPI:1700906625
Name:JOHNSTON, ALBERT MARTIN (RPH)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:MARTIN
Last Name:JOHNSTON
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 1:81 TERRACE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-7001
Mailing Address - Country:US
Mailing Address - Phone:304-292-8133
Mailing Address - Fax:
Practice Address - Street 1:446 GREENBAG ROAD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501
Practice Address - Country:US
Practice Address - Phone:304-296-4416
Practice Address - Fax:304-284-3615
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25575183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist