| NPI | 1467703991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GERARD POWERS Owner 304-255-6334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV SP0552432) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: WV SP0552432) |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: WV SP0552432) | |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2012-09-24 |