Healthcare Provider Details

I. General information

NPI: 1619051448
Provider Name (Legal Business Name): GRIFFITH & FEIL DRUG, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 CHESTNUT ST
KENOVA WV
25530-1235
US

IV. Provider business mailing address

1405 CHESTNUT ST
KENOVA WV
25530-1235
US

V. Phone/Fax

Practice location:
  • Phone: 304-453-2381
  • Fax: 304-453-1205
Mailing address:
  • Phone: 304-453-2381
  • Fax: 304-453-1205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberSP0550104
License Number StateWV

VIII. Authorized Official

Name: MS. CAROL CISCO
Title or Position: BOOKKEEPER SECRETARY
Credential:
Phone: 304-453-2381