Organization
KINGWOOD PHARMACY LLC
Active
Other names
Kingwood Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER REESE (OWNER/MANAGER)
(304) 329-3600
Entity
Organization
Contact information
Practice address
220 W MAIN ST, KINGWOOD, WV 26537-1419
(304) 329-3600
(304) 329-3356
Mailing address
220 W MAIN ST, KINGWOOD, WV 26537-1419
(304) 329-3600
(304) 329-3356
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0550847
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0143462000
—
WV
01
—
2143678
PK
—
Enumeration date
10/13/2005
Last updated
12/03/2014
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