Organization
PHARMACOLE INC
Active
Other names
MOUNDSVILLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JASON TURNER PHARMD (OWNER, PIC)
(304) 845-0390
Entity
Organization
Contact information
Practice address
118 LAFAYETTE AVE, MOUNDSVILLE, WV 26041-1029
(304) 845-0390
(304) 845-0391
Mailing address
118 LAFAYETTE AVE, MOUNDSVILLE, WV 26041-1029
(304) 845-0390
(304) 845-0391
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
NRP.022335850-03
OH
3336C0004X
Compounding Pharmacy
SP0550787
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0143297000
—
WV
01
—
2109812
PK
—
Enumeration date
10/20/2006
Last updated
03/15/2017
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