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Organization

MAIN PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LYDIA D MAIN (OWNER, R.PH.)
(304) 864-5711
Entity
Organization

Contact information

Practice address
MAIN STREET, MASONTOWN, WV 26542-0160
(304) 864-5711
Mailing address
PO BOX 160, MASONTOWN, WV 26542-0160
(304) 864-5711

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP0002010
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0142032000
WV
Enumeration date
12/19/2006
Last updated
08/22/2020
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