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Contact Information

JUDYS DRUG STORE INC
24 N MAIN ST
PETERSBURG, WV26847-1518
 Phone: 304-257-1044
 Fax: 304-257-2681
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutrition, Education

133NN1002X
 

Clinic/Center

261Q00000X
 

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
Indicates primary specialty

NPI Profile & details for JUDYS DRUG STORE INC

NPI Number 1407851769
LBN Legal business name JUDYS DRUG STORE INC
Authorized official DARIN JUDY - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/14/2005
Last updated 04/24/2012 - About 14 years ago
Identifiers
WV License # 30
WV License # 51D1024349
WV Medicaid 0141999000
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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