Healthcare Provider Details

I. General information

NPI: 1740263680
Provider Name (Legal Business Name): MCCULLOUGH & RIFFLE DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 EAST MAIN STREET
POMEROY OH
45769-1021
US

IV. Provider business mailing address

636 EAST MAIN STREET
POMEROY OH
45769-1021
US

V. Phone/Fax

Practice location:
  • Phone: 740-992-2955
  • Fax: 740-992-5244
Mailing address:
  • Phone: 740-992-2955
  • Fax: 740-992-5244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number020081300
License Number StateOH

VIII. Authorized Official

Name: MR. EDWARD J ZATTA
Title or Position: OWNER
Credential: R PH
Phone: 740-992-2955