Organization
PRUNTYS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY PUNTY RPH (OWNER PRESIDENT)
(304) 758-4300
Entity
Organization
Contact information
Practice address
220 MAIN ST, MIDDLEBOURNE, WV 26149
(304) 758-4300
(304) 758-4365
Mailing address
PO BOX 28, MIDDLEBOURNE, WV 26149-0028
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
SP0550195
WV
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0139623000
—
WV
01
—
5009116
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/21/2006
Last updated
02/08/2008
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