| NPI | 1407290224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAMES EBBERT Pharmacy Manager / Owner 304-553-5716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2013-04-23 |