Provider Demographics
NPI:1912979683
Name:PATTERSON, CORLEEN BARKER VIII (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:CORLEEN
Middle Name:BARKER
Last Name:PATTERSON
Suffix:VIII
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 SPRING RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-1121
Mailing Address - Country:US
Mailing Address - Phone:304-388-7909
Mailing Address - Fax:304-388-6735
Practice Address - Street 1:501 MORRIS ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1326
Practice Address - Country:US
Practice Address - Phone:304-388-7909
Practice Address - Fax:304-388-6735
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2950183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist