Organization
PASTM INC
Active
Other names
MEDICAP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PETER THOMAS RPH (PHARMACIST)
(304) 523-5003
Entity
Organization
Contact information
Practice address
4352 5TH STREET RD, HUNTINGTON, WV 25701-9558
(304) 523-5003
(304) 523-2462
Mailing address
4352 5TH STREET RD, HUNTINGTON, WV 25701-9558
(304) 523-5003
(304) 523-2462
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
SP0552277
WV
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5011894
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
6004009000
—
WV
Enumeration date
10/03/2006
Last updated
08/08/2008
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