Organization
WATERFRONT FAMILY PHARMACY LLC
Active
Other names
WATERFRONT FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RACHAEL HUDSON RPH (CO OWNER AND PHARM)
(304) 225-7979
Entity
Organization
Contact information
Practice address
215 DON KNOTTS BLVD, STE 120, MORGANTOWN, WV 26501-0113
(304) 225-7979
(304) 225-3784
Mailing address
215 DON KNOTTS BLVD, STE 120, MORGANTOWN, WV 26501-0113
(304) 225-7979
(304) 225-3784
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552324
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111571
PK
—
05
—
3810004619
—
WV
Enumeration date
07/22/2006
Last updated
06/01/2016
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