Organization
WESTSIDE PHARMACY INC
Active
Other names
WESTSIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DEVONNA MILLER WEST DRPH (PRESIDENT)
(304) 682-0444
Entity
Organization
Contact information
Practice address
RT 10 COOK PKWY AND LOGAN ST, OCEANA, WV 24870
(304) 682-0444
(304) 682-0447
Mailing address
PO BOX 69, OCEANA, WV 24870-0069
(304) 682-0444
(304) 682-0447
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552334
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111580
PK
—
05
—
3810005541
—
WV
Enumeration date
05/12/2006
Last updated
04/04/2016
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