Organization
CMC PHARMACY, LLC
Active
Parent organization
ELWYN PHARMACY GROUP, LLC
Other names
Med Center Specialty Pharmacy, BioMatrix Specialty Pharmacy WV
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELWYN PHARMACY GROUP, LLC
Authorized official
NICHOLAS KARALIS (CEO & PRESIDENT)
(610) 545-6040
Entity
Organization
Contact information
Practice address
3100 MACCORKLE AVE SE, SUITE 100, CHARLESTON, WV 25304-1223
(304) 344-8021
(304) 344-0655
Mailing address
3100 MACCORKLE AVE SE, SUITE 100, CHARLESTON, WV 25304-1223
(304) 344-8021
(304) 344-0655
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
SP0552442
WV
3336H0001X
Home Infusion Therapy Pharmacy
Primary
SP0552442
WV
3336S0011X
Specialty Pharmacy
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810025009
—
WV
Enumeration date
09/08/2016
Last updated
08/02/2021
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