Organization
GOOD LIFE APOTHECARY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK GOOD (OWNER)
(304) 552-8765
Entity
Organization
Contact information
Practice address
3212 PENN AVE # 8, CHARLESTON, WV 25302-4537
(304) 345-8600
(304) 345-8602
Mailing address
3212 PENNSYLVANIA AVE # 8, CHARLESTON, WV 25302-4537
(304) 345-8600
(304) 345-8602
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3910006007
—
WV
Enumeration date
07/15/2014
Last updated
03/02/2020
Update your record
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