| NPI | 1609979673 |
|---|---|
| Doing Business As | MVA FAIRMONT CLINIC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | NANCY L VANDERGRIFT President 304-366-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: WV SP0550384) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2021-08-12 |