Organization
STAATS PHARMACY AND HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN E CORKREAN III RPH (OWNER)
(304) 927-2980
Entity
Organization
Contact information
Practice address
100 E MAIN ST, SPENCER, WV 25276
(304) 927-2980
(304) 927-3190
Mailing address
PO BOX 67, 100 E MAIN ST, SPENCER, WV 25276-0067
(304) 927-2980
(304) 927-3190
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000200376
BLUE CROSS BLUE SHIELD
WV
05
—
0139438000
—
WV
Enumeration date
10/10/2006
Last updated
01/11/2016
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