Organization
FOOD LION LLC
Active
Other names
Food Lion Pharmacy #2194
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET M HAM (PRESIDENT)
(207) 885-7454
Entity
Organization
Contact information
Practice address
78 WORCHESTER DRIVE, FALLING WATERS, WV 25419
(304) 271-8836
(304) 271-8839
Mailing address
PO BOX 1000, MS3000, PORTLAND, ME 04104-5005
(207) 885-7454
(207) 885-3121
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810022093
—
WV
01
—
5055543
NCPDP PROVIDER NUMBER
—
Enumeration date
09/28/2011
Last updated
05/10/2017
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