Healthcare Provider Details
I. General information
NPI: 1124188305
Provider Name (Legal Business Name): PHARMCO VENTURES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3 CHATEAU GROVE LN
BARBOURSVILLE WV
25504-1627
US
IV. Provider business mailing address
3 CHATEAU GROVE LN
BARBOURSVILLE WV
25504-1627
US
V. Phone/Fax
- Phone: 304-736-8310
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | WV |
VIII. Authorized Official
Name:
DAVID
CARR
Title or Position: CEO
Credential: RPH
Phone: 304-736-8310