Provider Demographics
NPI:1316496656
Name:DIAMOND, KARINA (RPH)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:KARINA
Other - Middle Name:KAY
Other - Last Name:CHERNISKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:217 OAK LEE DR
Mailing Address - Street 2:SUITE 15
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-4871
Mailing Address - Country:US
Mailing Address - Phone:304-728-9041
Mailing Address - Fax:304-725-2365
Practice Address - Street 1:217 OAK LEE DR
Practice Address - Street 2:SUITE 15
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-4871
Practice Address - Country:US
Practice Address - Phone:304-728-9041
Practice Address - Fax:304-725-2365
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12863183500000X
WVRP0006750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVRP0006750OtherWV REGISTERED PHARMACIST LICENSE
AL12863OtherALABAMA REGISTERED PHARMACIST