Organization
WEST VIRGINIA UNIVERSITY HOSPITALS INC
Active
Other names
Mountaineer Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GRACE (PRESIDENT)
(304) 285-7348
Entity
Organization
Contact information
Practice address
390 BIRCH STREET, MORGANTOWN, WV 26505
(304) 285-7348
(304) 285-7349
Mailing address
PO BOX 8101, 1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26506-8101
(304) 285-7348
(304) 285-7349
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552488
WV
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149568
PK
—
05
—
3910006675
—
WV
Enumeration date
02/17/2015
Last updated
04/25/2025
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