Organization
J & B DRUG STORE, INC.
Active
Other names
J AND B DRUG STORE INC
Organization subpart
No
Provider details
NPI number
Authorized official
LEISA JARVIS-STOVER (MANAGER AND CO OWNER)
(304) 354-7737
Entity
Organization
Contact information
Practice address
352 MAIN STREET, GRANTSVILLE, WV 26147
(304) 354-7737
(304) 354-7807
Mailing address
PO BOX 560, GRANTSVILLE, WV 26147-0560
(304) 354-7737
(304) 354-7807
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0550136
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142545000
—
WV
01
—
2109383
PK
—
Enumeration date
07/01/2005
Last updated
10/20/2014
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