Organization
SUNCREST PHARMACY
Active
Other names
CHEAT LAKE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN MONTI RPH (CO OWNER)
(304) 594-0132
Entity
Organization
Contact information
Practice address
509 ASHEBROOKE SQ, MORGANTOWN, WV 26508-4465
(304) 594-0132
(304) 594-0134
Mailing address
509 ASHEBROOKE SQ, MORGANTOWN, WV 26508-4465
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0551182
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142311002
—
WV
01
—
5010145
OTHER ID NUMBER
—
Enumeration date
11/23/2005
Last updated
09/13/2007
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