Provider Demographics
NPI:1992718597
Name:FUMICH, DENEEN M (RPH)
Entity type:Individual
Prefix:MRS
First Name:DENEEN
Middle Name:M
Last Name:FUMICH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-4250
Mailing Address - Country:US
Mailing Address - Phone:304-599-2595
Mailing Address - Fax:304-285-6437
Practice Address - Street 1:31 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-4250
Practice Address - Country:US
Practice Address - Phone:304-599-2595
Practice Address - Fax:304-285-6437
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist