| NPI | 1134569668 |
|---|---|
| Doing Business As | MOUNTAINEER MEDICAL PHARMACY LLC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL KOVACK Pharm Mgr 304-423-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV SP0552456) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2013-10-26 |