Organization
DISCOUNT EMPORIUM INC
Active
Other names
DRUG EMPORIUM
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY LEONARD (V P PHARMACY)
(304) 345-4836
Entity
Organization
Contact information
Practice address
1603 KANAWHA BLVD W, CHARLESTON, WV 25387-2535
(304) 345-3784
(304) 345-4999
Mailing address
1601 KANAWHA BLVD W, SU 200, CHARLESTON, WV 25387-2539
(304) 345-4836
(304) 345-4972
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
MP0550147
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140522000
—
WV
01
—
2110580
PK
—
Enumeration date
09/21/2006
Last updated
04/12/2017
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