Provider Demographics
NPI:1235979501
Name:ROSS, MARLEIGH PAIGE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARLEIGH
Middle Name:PAIGE
Last Name:ROSS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 STRAWBERRY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-2621
Mailing Address - Country:US
Mailing Address - Phone:304-840-4324
Mailing Address - Fax:
Practice Address - Street 1:2 COURTYARD LN
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1015
Practice Address - Country:US
Practice Address - Phone:304-908-5586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-25
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0013720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist