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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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