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Organization

LARRY'S DRIVE IN PHARMACY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LARRY E BOWEN (OWNER)
(304) 369-0209
Entity
Organization

Contact information

Practice address
313 MADISON AVE, MADISON, WV 25130-1510
(304) 369-0209
(304) 369-1994
Mailing address
313 MADISON AVE, MADISON, WV 25130-1510
(304) 369-0209
(304) 369-1994

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
SP0550784
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0143286000
WV
Enumeration date
01/18/2007
Last updated
08/22/2020
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