Organization
JSB ENTERPRISES INC
Active
Other names
SOUTH BERKELEY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
J SCOTT BOYD RPH (PRESIDENT)
(304) 229-3879
Entity
Organization
Contact information
Practice address
5054 GERRARDSTOWN ROAD, INWOOD, WV 25428
(304) 229-2400
(304) 229-2906
Mailing address
PO BOX 1903, INWOOD, WV 25428-1903
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552336
WV
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5054301
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
6271410001
—
WV
Enumeration date
08/10/2006
Last updated
03/03/2011
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