| NPI | 1417054255 |
|---|---|
| Doing Business As | GOODYKOONTZ DRUG STORE INC |
| Entity Type | Organization |
| Authorized Contact | JERRY BOVENIZER President 304-324-7601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV SP0550098) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-09-19 |