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Organization
UBC LATE STAGE INC
Active
Organization
UBC LATE STAGE INC
Active
Other names
UBC Late Stage, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
AMY MILLER PHARMD (DIRECTOR)
(304) 291-7524
Entity
Organization
Contact information
Practice address
200 PINECREST PLZ, MORGANTOWN, WV 26505-8065
(304) 291-7524
(304) 292-6391
Mailing address
200 PINECREST PLZ, MORGANTOWN, WV 26505-8065
(304) 291-7524
(304) 292-6391
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
MO0560083
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5055151
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/15/2010
Last updated
10/26/2012
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