Organization
VILLAGE PHARMACY INC
Active
Other names
VILLAGE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY WILLIAMS RPH (PRESIDENT)
(304) 745-3301
Entity
Organization
Contact information
Practice address
36 RAILROAD ST, LOST CREEK, WV 26385
(304) 745-3301
(304) 745-5683
Mailing address
PO BOX 310, LOST CREEK, WV 26385-0310
(304) 745-3301
(304) 745-5683
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0550791
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0143308000
—
WV
01
—
2109852
PK
—
Enumeration date
10/12/2006
Last updated
08/12/2016
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