| NPI | 1124030366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA SIKORA PIC And COO Wner 304-723-1818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV SP0550004) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2013-05-16 |