Healthcare Provider Details

I. General information

NPI: 1265468029
Provider Name (Legal Business Name): RSM PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 COURT ST
ELIZABETH WV
26143-1109
US

IV. Provider business mailing address

PO BOX 74
ELIZABETH WV
26143-0074
US

V. Phone/Fax

Practice location:
  • Phone: 304-275-4687
  • Fax: 304-275-4502
Mailing address:
  • Phone: 304-275-4687
  • Fax: 304-275-4502

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 Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberSP0552397
License Number StateWV

VIII. Authorized Official

Name: RONALD MCKINNEY
Title or Position: OWNER/PHARMACIST
Credential: PHARM D
Phone: 304-275-4687