Healthcare Provider Details

I. General information

NPI: 1952472383
Provider Name (Legal Business Name): BELINGTON PRESCRIPTION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 BRIDGE ST
BELINGTON WV
26250-9319
US

IV. Provider business mailing address

206 BRIDGE ST PO BOX 1050
BELINGTON WV
26250-9319
US

V. Phone/Fax

Practice location:
  • Phone: 304-823-1198
  • Fax: 304-823-1661
Mailing address:
  • Phone: 304-823-1198
  • Fax: 304-823-1661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberSP0550639
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW A. GENIN
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 304-823-1198