Healthcare Provider Details

I. General information

NPI: 1538611520
Provider Name (Legal Business Name): FRUTH PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2016
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4541 5TH STREET RD
HUNTINGTON WV
25701-9112
US

IV. Provider business mailing address

4541 5TH STREET RD
HUNTINGTON WV
25701-9112
US

V. Phone/Fax

Practice location:
  • Phone: 304-522-6090
  • Fax: 304-522-6094
Mailing address:
  • Phone: 304-522-6090
  • Fax: 304-522-6094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberMP0552424
License Number StateWV

VIII. Authorized Official

Name: ANDREW THOMAS BECKER
Title or Position: CEO
Credential:
Phone: 304-675-1612