Provider Demographics
NPI:1962807115
Name:HEMERICK, MELVIN J (PHARM D)
Entity type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:J
Last Name:HEMERICK
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:HC 61 BOX 301
Mailing Address - Street 2:
Mailing Address - City:CAPON BRIDGE
Mailing Address - State:WV
Mailing Address - Zip Code:26711
Mailing Address - Country:US
Mailing Address - Phone:304-856-2901
Mailing Address - Fax:304-856-2907
Practice Address - Street 1:US ROUTE 50
Practice Address - Street 2:BEAR GARDEN PLAZA BLDG 2 SUITES 1 & 2
Practice Address - City:CAPON BRIDGE
Practice Address - State:WV
Practice Address - Zip Code:26711
Practice Address - Country:US
Practice Address - Phone:304-856-2901
Practice Address - Fax:304-856-2907
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist