| NPI | 1912155102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN LOUISE PAXTON Member 304-865-2315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: WV 809506) |
| Enumeration Date | 2008-08-31 |
| Last Update Date | 2008-11-17 |