Organization
WHITE HALL PHARMACY LLC
Active
Other names
WHITE HALL PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI VILAIN RPH (OWNER)
(304) 368-9355
Entity
Organization
Contact information
Practice address
1325 LOCUST AVE, FAIRMONT, WV 26554-1435
(304) 368-9355
(304) 367-8601
Mailing address
1325 LOCUST AVE, FAIRMONT, WV 26554-1435
(304) 368-9355
(304) 367-8601
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
SP0552374
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810012153
—
WV
01
—
5010905
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/13/2006
Last updated
03/27/2012
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