| NPI | 1386131050 |
|---|---|
| Doing Business As | MED-MART PHARMACY FAIRMONT |
| Entity Type | Organization |
| Authorized Contact | IBRAHIM KADDOURAH Owner/PIC 304-367-9122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WV SP0552522) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2019-12-11 |