| NPI | 1619051448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL CISCO Bookkeeper Secretary 304-453-2381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV SP0550104) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2008-03-12 |