Provider Demographics
NPI:1124506993
Name:DELANCEY, ALLISON (PHARMD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:DELANCEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 PIKE RD
Mailing Address - Street 2:
Mailing Address - City:ELLENBORO
Mailing Address - State:WV
Mailing Address - Zip Code:26346-6724
Mailing Address - Country:US
Mailing Address - Phone:304-483-4486
Mailing Address - Fax:
Practice Address - Street 1:401 MATTHEW ST STE 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1635
Practice Address - Country:US
Practice Address - Phone:740-434-0140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0010624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist