| NPI | 1225180136 |
|---|---|
| Former Legal Business Name | BURNSVILLE DRUG STORE PLLC |
| Entity Type | Organization |
| Authorized Contact | DAVID MICHAEL MCQUAIN Pharmacist 304-853-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WV 6062) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV 6062) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2014-09-11 |