Organization
HIGHLANDER PHARMACY INC.
Active
Other names
HIGHLANDER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY KESECKER (PRESIDENT AND CEO)
(304) 847-5151
Entity
Organization
Contact information
Practice address
117 BACK FORK ST, WEBSTER SPRINGS, WV 26288-1032
(304) 847-5151
(304) 847-2800
Mailing address
117 BACK FORK ST, WEBSTER SPRINGS, WV 26288-1032
(304) 847-5151
(304) 847-2800
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0551261
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0141405000
—
WV
01
—
5010878
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/09/2005
Last updated
08/31/2011
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