| NPI | 1811381585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD LEE REBICH Pharmacist Manager 304-233-3868 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV SP0552443) |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2015-03-20 |