Mountaineer Medical Pharmacy

LBN: Mountaineer Medical Office Building Pharmacy
Mountaineer Medical Pharmacy is an health care organization with primary practice located at 120 Medical Park Dr Ste 102 , Bridgeport WV 26330-9013. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Mountaineer Medical Office Building Pharmacy can be contacted via phone (304) 423-5200, or through Franz, Charles Bradley via phone (304) 624-7200.

Contact Information

Primary practice address
120 Medical Park Dr Ste 102 Bridgeport WV 26330-9013
Phone: (304) 423-5200
Fax: (304) 848-6050
Website:
Map and Directions
Authorized official contact:
Name: Franz, Charles Bradley
Phone: (304) 624-7200

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X SP0552423 West Virginia

Profile Details

NPI number 1538445101
LBN Legal business name Mountaineer Medical Office Building Pharmacy
DBA Doing business as Mountaineer Medical Pharmacy
Authorized official Franz, Charles Bradley
Entity Organization
Organization subpart 1 No
Enumeration date Oct 27th, 2011
Last updated Jun 13th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538445101 NPPES
Other 2132729 PK
MEDICAID 3810022200 PK

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