Organization
MAIN STREET PHARMACY INC
Active
Organization
MAIN STREET PHARMACY INC
Active
Parent organization
MAIN STREET PHARMACY, INC
Other names
Stanaford Infusion Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAIN STREET PHARMACY, INC
Authorized official
JAWAD SHERWANI (CEO)
(304) 860-1446
Entity
Organization
Contact information
Practice address
269 STANAFORD RD, SUITE B, BECKLEY, WV 25801-3139
(304) 860-1446
(304) 894-8513
Mailing address
269 STANAFORD RD, SUITE B, BECKLEY, WV 25801-3139
(304) 860-1446
(304) 894-8513
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154625283
BCBS
WV
05
—
3810019416
—
WV
Enumeration date
01/04/2011
Last updated
07/14/2011
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