Organization
GRANT MEMORIAL HOSPITAL HOME INFUSION THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BROSH RPH (PIC)
(304) 257-1026
Entity
Organization
Contact information
Practice address
RT 4 AND 28, PETERSBURG, WV 26847
(304) 257-1026
(304) 257-9622
Mailing address
RT 4 AND 28, PETERSBURG, WV 26847
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
OP0551225
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5010549
OTHER ID NUMBER
—
Enumeration date
08/05/2007
Last updated
08/05/2007
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