National Provider Identifier Database

JOHN MANCHIN III
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

JOHN MANCHIN III
181 MIDDLETOWN CIR
FAIRMONT, WV26554-2015
Phone: 304-367-9122
Fax: 304-367-9125
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X

* Indicates primary specialty

NPI Profile & details for JOHN MANCHIN III

NPI Number 1689849804
Legal business name
LBN
JOHN MANCHIN III
Authorized official JOHN MANCHIN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 04/29/2008
Last updated 04/25/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • WV License #: SP0552377
  • WV Medicaid: 3810011348
  • Other: 2111736 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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