Healthcare Provider Details

I. General information

NPI: 1932573425
Provider Name (Legal Business Name): WV CHS PHARMACY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15063 MACCORKLE AVE., SE
CABIN CREEK WV
25035-8047
US

IV. Provider business mailing address

10123 ALLIANCE RD
BLUE ASH OH
45242-4887
US

V. Phone/Fax

Practice location:
  • Phone: 304-595-4900
  • Fax: 304-595-4652
Mailing address:
  • Phone: 513-489-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberSP0552501
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH G MAREK
Title or Position: CHIEF PHARMACY OFFICER
Credential: RPH
Phone: 513-530-1808