Provider Demographics
NPI:1053600635
Name:HAMRICK, KENNEY RAY III (PHARMD)
Entity type:Individual
Prefix:
First Name:KENNEY
Middle Name:RAY
Last Name:HAMRICK
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:26288-1046
Mailing Address - Country:US
Mailing Address - Phone:304-847-2900
Mailing Address - Fax:
Practice Address - Street 1:306 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WEBSTER SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:26288-1046
Practice Address - Country:US
Practice Address - Phone:304-847-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007479183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist