Organization
MEADOW RIVER PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ROBERT BURR RPH (PHARMACIST)
(304) 438-6040
Entity
Organization
Contact information
Practice address
611 MAIN ST, RAINELLE, WV 25962-1242
(304) 438-6040
(304) 438-5888
Mailing address
611 MAIN ST, RAINELLE, WV 25962-1242
(304) 438-6040
(304) 438-5888
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
SP0552303
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6010030000
—
WV
Enumeration date
11/01/2006
Last updated
08/22/2020
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