| NPI | 1154621340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP MICHAEL Pharmacist 304-756-1260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV MP0552390) |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2014-07-14 |