Organization
FIVE STAR PHARMACY
Active
Other names
Shady Spring Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE DIANE SISSON RPH (CO-OWNER)
(304) 573-1114
Entity
Organization
Contact information
Practice address
2795 RITTER DR, SHADY SPRING, WV 25918-8515
(304) 573-1114
Mailing address
2795 RITTER DR, SHADY SPRING, WV 25918-8515
(304) 573-1114
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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