Mountain Lake Pharmacy Inc in Summersville - Community/retail Pharmacy
Mountain Lake Pharmacy Inc - NPI 1336228006
Mountain Lake Pharmacy Inc is a Community/retail Pharmacy in Summersville, . Mountain Lake Pharmacy Inc practices all healthcare services and medical treatments related to Community/retail Pharmacy. The NPI Number for Mountain Lake Pharmacy Inc is 1336228006. The last update date is 2010-09-10.
Mountain Lake Pharmacy Inc's current location address is 1129 Broad St, Summersville, . You can contact this provider via phone number 3048729000 and fax number 3048724419. The mailing address for Mountain Lake Pharmacy Inc is 1129 Broad St, Summersville, . To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Mountain Lake Pharmacy Inc |
|---|---|
| Address | 1129 Broad St, Summersville, |
| Phone Number | 3048729000 |
| Fax Number | 3048724419 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Boone Howard |
| Credentials | RPH |
| Telephone Number | 3048729000 |
NPI Number Detail
| NPI Number | 1336228006 |
|---|---|
| Provider Enumeration Date | 2006-11-03 |
| Last Updated Date | 2010-09-10 |
Provider Mailing Address Detail
| Address | 1129 Broad St |
|---|---|
| City | Summersville |
| State | (WV) |
| Post Code | 266511838 |
| Phone Number | 3048729000 |
| Fax Number | 3048724419 |
Provider's Primary Taxonomy Detail
| Speciality | Community/retail Pharmacy |
|---|---|
| Taxonomy | 3336C0003X |
| Licence No | SP0552314 |
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Definition: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing pr |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6001398000 | WV | -- | |
| 5054046 | NCPDP PROVIDER IDENTIFICATION |
Post Comment/ Review Below
What is the unique identifier code issued to Mountain Lake Pharmacy Inc by the Centers for Medicare & Medicaid Services (CMS)?
The Mountain Lake Pharmacy Inc has been assigned the NPI (National Provider Identifier) 1336228006. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete physical location address of Mountain Lake Pharmacy Inc?
The Mountain Lake Pharmacy Inc is physically situated at 1129 Broad St, in the city of Summersville, state of WV, with the postal code 266511838.
What is Mountain Lake Pharmacy Inc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Mountain Lake Pharmacy Inc is Community/retail Pharmacy, and the taxonomy code that categorizes this field of expertise is 3336C0003X.
On what date did the Mountain Lake Pharmacy Inc receive the assignment of its 1336228006 from the Centers for Medicare & Medicaid Services?
The Mountain Lake Pharmacy Inc was issued its 1336228006 by the Centers for Medicare & Medicaid Services on 2006-11-03.
When was the information regarding Mountain Lake Pharmacy Inc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Mountain Lake Pharmacy Inc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2010-09-10.
NPI Number: 1588667679
Address: 9104 Babcock Blvd, Pittsburgh, PA