Organization
BYPASS PHARMACY, INC
Active
Other names
BYPASS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SIDDARTHAN ILANGOVAN (PRESIDENT)
(304) 222-3064
Entity
Organization
Contact information
Practice address
104 S EISENHOWER DR, BECKLEY, WV 25801-4930
(304) 256-2006
(304) 860-1968
Mailing address
104 S EISENHOWER DR, BECKLEY, WV 25801-4930
(304) 256-2006
(304) 860-1968
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552407
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5055252
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/24/2010
Last updated
12/06/2012
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