| NPI | 1679728448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLAND F CHALIFOUX, Owner 304-242-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: WV 2077) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2008-11-20 |