Organization
PROFESSIONAL PHARMACY INC
Active
Other names
CARRIAGE DRIVE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
W KLUESNER (PRESIDENT OWNER PIC)
(304) 252-5349
Entity
Organization
Contact information
Practice address
350 CARRIAGE DR, BECKLEY, WV 25801-2812
(304) 252-5349
(304) 252-5386
Mailing address
350 CARRIAGE DR, BECKLEY, WV 25801-2812
(304) 252-5349
(304) 252-5386
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0550190
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140316000
—
WV
01
—
2110369
PK
—
Enumeration date
09/20/2006
Last updated
02/17/2015
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