# CAMDEN ON GAULEY MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Camden Family Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558757955
- **Authorized official:** MARGARET HICKEY (CEO)
- **Authorized official phone:** (304) 226-5725

## Contact information

- **Practice address:** 415 MAIN ST, SUMMERSVILLE, WV 26651-1343
- **Practice address phone:** (304) 872-1663
- **Practice address fax:** (681) 355-0362
- **Mailing address:** 55 FRIENDS R FUN DR, SUMMERSVILLE, WV 26651-9514
- **Mailing address phone:** (304) 872-1663
- **Mailing address fax:** (681) 355-0362

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | SP0552479 | WV | Yes |

## Other

- **Enumeration date:** 04/13/2015
- **Last updated:** 07/08/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2150879 | PK | — |