Organization
CHARLESTON MEDICAL CENTER PHARMACY
Active
Other names
CHARLESTON MEDICAL CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BARTSCH RPH (PHARM)
(304) 344-8021
Entity
Organization
Contact information
Practice address
3100 MACCORKLE AVE SE, STE 100, CHARLESTON, WV 25304-1223
(304) 344-8021
(304) 344-0655
Mailing address
3100 MACCORKLE AVE SE, STE 100, CHARLESTON, WV 25304-1223
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0550648
WV
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00143130000
—
WV
01
—
5001588
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
8504598
—
WV
Enumeration date
11/03/2006
Last updated
04/07/2009
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