Organization
BUFFALO DRUG INC
Active
Other names
Buffalo Drug
Organization subpart
No
Provider details
NPI number
Authorized official
JACKSON NOEL (OWNER/RPH)
(304) 553-3383
Entity
Organization
Contact information
Practice address
1905 BUFFALO ROAD, BUFFALO, WV 25033
(304) 937-3000
(304) 937-4141
Mailing address
PO BOX 7, BUFFALO, WV 25033-0007
(304) 937-3000
(304) 937-4141
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552422
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130850
PK
—
05
—
3810020926
—
WV
Enumeration date
06/22/2011
Last updated
08/25/2014
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