| NPI | 1952849093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES DAVID BURDETTE President/Owner 304-369-0209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WV SP0552509) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2017-02-09 |