Organization
JOHN MANCHIN III
Active
Other names
MANCHIN FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MANCHIN III B.S. (OWNER)
(304) 367-9122
Entity
Organization
Contact information
Practice address
181 MIDDLETOWN CIR, FAIRMONT, WV 26554-2015
(304) 367-9122
(304) 367-9125
Mailing address
181 MIDDLETOWN CIR, FAIRMONT, WV 26554-2015
(304) 367-9122
(304) 367-9125
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
SP0552377
WV
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111736
PK
—
05
—
3810011348
—
WV
Enumeration date
04/29/2008
Last updated
04/25/2017
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