Organization
STOUTS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE D. PFALZGRAF R.PH. (PRESIDENT)
(304) 422-6511
Entity
Organization
Contact information
Practice address
3007 DUDLEY AVE, PARKERSBURG, WV 26104-1817
(304) 422-6511
(304) 485-8832
Mailing address
PO BOX 4321, PARKERSBURG, WV 26104-4321
(304) 422-6511
(304) 485-8832
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
SP0552220
WV
333600000X
Pharmacy
Primary
SP0552220
WV
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0141780000
—
WV
01
—
5011301
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/13/2006
Last updated
09/28/2010
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