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Contact Information

COAL RIVER PHARMACY LLC
21189 COAL RIVER RD
COMFORT, WV25049
 Phone: 304-837-3777
 Fax: 304-837-3776
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for COAL RIVER PHARMACY LLC

NPI Number 1891970414
LBN Legal business name COAL RIVER PHARMACY LLC
Authorized official STEPHANIE MASSEY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/02/2008
Last updated 04/13/2021 - About 5 years ago
Identifiers
WV License # SP0552365
WV Medicaid 3810011065
Other 2111653 PK
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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