| NPI | 1578033841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW THOMAS BECKER Director Of Pharmacy Administration 304-675-1612 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2020-04-15 |