Provider Demographics
NPI:1366747099
Name:COLE, DAVID MICHAEL (PHARM-D)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MICHAEL
Last Name:COLE
Suffix:
Gender:M
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 DELIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:MARTINS FERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43935
Mailing Address - Country:US
Mailing Address - Phone:304-639-1034
Mailing Address - Fax:
Practice Address - Street 1:520 NORTH STATE ROUTE 2
Practice Address - Street 2:
Practice Address - City:NEW MARTINSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26155
Practice Address - Country:US
Practice Address - Phone:304-455-1790
Practice Address - Fax:305-455-3158
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist