Organization
GOODYKOONTZ DRUG STORES INC
Active
Other names
GOODYKOONTZ DRUG STORE INC
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY BOVENIZER RPH (PRESIDENT)
(304) 324-7601
Entity
Organization
Contact information
Practice address
2924 EAST CUMBERLAND ROAD, BLUEFIELD, WV 24701
(304) 325-7121
(304) 327-9701
Mailing address
2924 EAST CUMBERLAND ROAD, BLUEFIELD, WV 24701
(304) 325-7121
(304) 327-9701
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0550098
WV
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0085046995
—
VA
05
—
0141899000
—
WV
01
—
2109351
PK
—
Enumeration date
09/20/2006
Last updated
09/19/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up