Provider Demographics
NPI:1063701167
Name:MAROZZI, GINA MARIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:MARIE
Last Name:MAROZZI
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 1:208 S PIKE ST
Mailing Address - Street 2:
Mailing Address - City:SHINNSTON
Mailing Address - State:WV
Mailing Address - Zip Code:26431-1122
Mailing Address - Country:US
Mailing Address - Phone:304-592-8003
Mailing Address - Fax:304-592-1418
Practice Address - Street 1:208 S PIKE ST
Practice Address - Street 2:
Practice Address - City:SHINNSTON
Practice Address - State:WV
Practice Address - Zip Code:26431-1122
Practice Address - Country:US
Practice Address - Phone:304-592-8003
Practice Address - Fax:304-592-1418
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV6280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist