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Organization
JOHN MANCHIN III
Active
Organization
JOHN MANCHIN III
Active
Other names
MANCHIN FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MANCHIN III B.S. (OWNER)
(304) 367-9122
Entity
Organization
Contact information
Practice address
181 MIDDLETOWN CIR, FAIRMONT, WV 26554-2015
(304) 367-9122
(304) 367-9125
Mailing address
181 MIDDLETOWN CIR, FAIRMONT, WV 26554-2015
(304) 367-9122
(304) 367-9125
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
SP0552377
WV
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111736
PK
—
05
—
3810011348
—
WV
Enumeration date
04/29/2008
Last updated
04/25/2017
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