Healthcare Provider Details

I. General information

NPI: 1225065303
Provider Name (Legal Business Name): LOUCAS-KARNOUPAKIS ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 CAROLINA AVE
CHESTER WV
26034-1319
US

IV. Provider business mailing address

PO BOX 198 501 CAROLINA AVE
CHESTER WV
26034
US

V. Phone/Fax

Practice location:
  • Phone: 304-387-2731
  • Fax: 304-387-1369
Mailing address:
  • Phone: 304-387-2731
  • Fax: 304-387-1369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberMP0550032
License Number StateWV

VIII. Authorized Official

Name: MR. JAMES THOMAS KARNOUPAKIS
Title or Position: PRES
Credential: RPH
Phone: 304-387-2731