| NPI | 1376884213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SKIP GJOLBERG Administrator 304-473-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336I0012X Pharmacy, Institutional Pharmacy (Licence: WV IP0550608) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WV IP0550608) |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2023-10-20 |