Healthcare Provider Details

I. General information

NPI: 1174864011
Provider Name (Legal Business Name): FRUTH PHARMACY OF OHIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 12/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 STATE ROUTE 141
IRONTON OH
45638-5213
US

IV. Provider business mailing address

FRUTH CORPORATE OFFICES 4016 OHIO RIVER ROAD
POINT PLEASANT WV
25550
US

V. Phone/Fax

Practice location:
  • Phone: 740-532-7943
  • Fax: 740-532-8555
Mailing address:
  • Phone: 304-675-1612
  • Fax: 304-675-7905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number02-2289750
License Number StateOH

VIII. Authorized Official

Name: MARY HARRIS
Title or Position: MANAGED CARE ADM
Credential:
Phone: 304-675-1612