| NPI | 1942012398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH WADE Owner 304-252-6332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2025-01-23 |
| Last Update Date | 2025-01-24 |