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Contact Information

PETERSTOWN PHARMACY
105 MARKET STREET
PETERSTOWN, WV24963
 Phone: 304-753-5074
 Fax: 304-753-5078
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PETERSTOWN PHARMACY

NPI Number 1326205246
LBN Legal business name PETERSTOWN PHARMACY
Authorized official ROBERT MASSIE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/19/2008
Last updated 06/06/2008 - About 18 years ago
Identifiers
WV License # SP0552221
WV Medicaid 0141778000
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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