Healthcare Provider Details

I. General information

NPI: 1942387287
Provider Name (Legal Business Name): FRUTH PHARMACY OF OHIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E MAIN ST
POMEROY OH
45769-1115
US

IV. Provider business mailing address

4016 OHIO RIVER RD
POINT PLEASANT WV
25550-3257
US

V. Phone/Fax

Practice location:
  • Phone: 740-992-1536
  • Fax: 740-992-1608
Mailing address:
  • Phone: 740-992-1536
  • Fax: 304-675-7905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number022522300-03
License Number StateOH

VIII. Authorized Official

Name: ANDREW BECKER
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 304-675-1612