Organization
NORRIS PHARMACY INC
Active
Other names
NORRIS PHARMACY, MEDICINE SHOPPE 2039
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN RIDER (OWNER)
(304) 366-2710
Entity
Organization
Contact information
Practice address
300 STATE RT 20, PINE GROVE, WV 26419
(304) 889-3131
(304) 889-3315
Mailing address
PO BOX 389, PINE GROVE, WV 26419-0389
(304) 889-3131
(304) 889-3315
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552349
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396818423
—
WV
01
—
2111634
PK
—
Enumeration date
11/16/2006
Last updated
03/15/2017
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