Organization
BIG FOUR DRUGSTORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MARK ELLISON RPH (PHARMACIST MANAGER)
(304) 466-2323
Entity
Organization
Contact information
Practice address
300 TEMPLE ST, HINTON, WV 25951-0688
(304) 466-2323
(304) 466-2366
Mailing address
300 TEMPLE ST, HINTON, WV 25951-0688
(304) 466-2323
(304) 466-2366
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
SP0550015
WV
333600000X
Pharmacy
SP0550015
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0139587000
—
WV
Enumeration date
12/30/2005
Last updated
09/11/2025
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