| NPI | 1184015802 |
|---|---|
| Doing Business As | MOUNTAINEER PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOEDELL GONZAGA Director 304-598-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV SP0552488) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2023-12-08 |