Organization
ALUM CREEK PHARMACY,INC
Active
Other names
ALUM CREEK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP MICHAEL (OWNER)
(304) 546-7722
Entity
Organization
Contact information
Practice address
2162 CHILDRESS RD, ALUM CREEK, WV 25003-9546
(304) 756-2180
Mailing address
PO BOX 95, ALUM CREEK, WV 25003-0095
(304) 756-2180
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
SP0552444
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5055795
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/26/2013
Last updated
02/26/2013
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