| NPI | 1346686169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON KEIPER Pharmacy Manager 304-619-3518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WV SP0552454) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2018-05-25 |