Healthcare Provider Details

I. General information

NPI: 1811156417
Provider Name (Legal Business Name): HARTS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1073 MCCLELLAN HIGHWAY
HARTS WV
25524
US

IV. Provider business mailing address

PO BOX 250
HARTS WV
25524-0250
US

V. Phone/Fax

Practice location:
  • Phone: 304-855-5616
  • Fax: 304-855-5614
Mailing address:
  • Phone: 304-855-5616
  • Fax: 304-855-5614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberMP0552363
License Number StateWV

VIII. Authorized Official

Name: VIRGIL MERRITT
Title or Position: PRESIDENT
Credential: RPH
Phone: 304-752-7295