Organization
MADISON FAMILY PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DAVID BURDETTE (PRESIDENT/OWNER)
(304) 369-0209
Entity
Organization
Contact information
Practice address
313 MADISON AVE, MADISON, WV 25130-1510
(304) 369-0209
(304) 369-1994
Mailing address
313 MADISON AVE, MADISON, WV 25130-1510
(304) 369-0209
(304) 369-1994
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
SP0552509
WV
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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