Organization
MAIN STREET PHARMACY
Active
Other names
Mount Hope Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAWED SHERWANI (OWNER/ PHARMACIST)
(304) 465-7200
Entity
Organization
Contact information
Practice address
301 MAIN ST, MOUNT HOPE, WV 25880-1105
(304) 877-7923
(304) 877-7921
Mailing address
301 MAIN ST, MOUNT HOPE, WV 25880-1105
(304) 877-7923
(304) 877-7921
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
SP0552434
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5055694
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/01/2012
Last updated
09/02/2014
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