| NPI | 1629078118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW BECKER Director Of Pharmacy 304-675-1612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WV MP0552421) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2017-01-18 |