Healthcare Provider Details

I. General information

NPI: 1124069943
Provider Name (Legal Business Name): RHONDAS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3413B ROBERT C BYRD DR
BECKLEY WV
25801
US

IV. Provider business mailing address

3413B ROBERT C BYRD DR
BECKLEY WV
25801
US

V. Phone/Fax

Practice location:
  • Phone: 304-255-6337
  • Fax: 304-255-6388
Mailing address:
  • Phone: 304-255-6337
  • Fax: 304-255-6388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberSP0552332
License Number StateWV

VIII. Authorized Official

Name: RHONDA ROSE
Title or Position: OWNER/PRESIDENT/CEO
Credential: RPH
Phone: 304-255-6337