| NPI | 1649292228 |
|---|---|
| Doing Business As | MEDBROOK MEDICAL ASSOCI INC PHCY |
| Entity Type | Organization |
| Authorized Contact | KELLY NELSON Medical Director/ President 304-842-7186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV SP0552291) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2010-08-11 |