| NPI | 1194155812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY PAINTER Billing Specialist 304-366-2710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WV 1467459545) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2013-11-15 |