| NPI | 1811090954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY SKEENES Owner 304-756-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WV SP0552446) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2013-03-25 |