| NPI | 1942499223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN WILSON Manager 304-294-5447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV 552361) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2022-10-21 |