Organization
CRAB ORCHARD PHARMACY INC
Active
Other names
CRAB ORCHARD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD SALLAZ RPH (OWNER/PRES/PIC)
(304) 253-7474
Entity
Organization
Contact information
Practice address
1299 ROBERT C BYRD DRIVE, CRAB ORCHARD, WV 25827
(304) 253-7474
(304) 253-7495
Mailing address
PO BOX 276, CRAB ORCHARD, WV 25827-0276
(304) 253-7474
(304) 253-7495
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552359
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139667000
—
WV
01
—
2110661
PK
—
Enumeration date
10/23/2006
Last updated
02/21/2017
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