Organization
KMART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW SCOTT (PHARMACIST)
(304) 588-3553
Entity
Organization
Contact information
Practice address
6531 MACCORKLE AVE SE, CHARLESTON, WV 25304-2921
(304) 925-4721
Mailing address
6531 MACCORKLE AVE SE, CHARLESTON, WV 25304-2921
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP0008667
WV
Other
Enumeration date
09/22/2014
Last updated
09/22/2014
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