| NPI | 1366062671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SHELDON CARPENTER Pharmacy Manager 304-619-2401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-10-05 |