Organization
DAVIS MEMORIAL HOSPITAL
Active
Other names
Davis Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY L WILDMAN (DIRECTOR OF REVENUE CYCLE)
(304) 637-3622
Entity
Organization
Contact information
Practice address
812 GORMAN AVE STE 204, ELKINS, WV 26241-3181
(304) 637-3622
Mailing address
812 GORMAN AVE, PO BOX 1484, ELKINS, WV 26241
(304) 637-3622
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
07/01/2022
Last updated
05/07/2024
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