Organization
GASSAWAY DRUG COMPANY
Active
Other names
CARL WALKERS DRUGSTORE
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK GRINDO (OWNER)
(304) 364-5193
Entity
Organization
Contact information
Practice address
620 ELK ST, GASSAWAY, WV 26624-1136
(304) 364-5193
(304) 364-5313
Mailing address
620 ELK ST, GASSAWAY, WV 26624-1136
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0550848
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5002100
OTHER ID NUMBER
—
05
—
8884830801
—
WV
Enumeration date
10/10/2005
Last updated
09/13/2007
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