Healthcare Provider Details

I. General information

NPI: 1588718878
Provider Name (Legal Business Name): NEWPAGE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 ORCHARD ST
PIEDMONT WV
26750-1036
US

IV. Provider business mailing address

22 ORCHARD ST
PIEDMONT WV
26750-1036
US

V. Phone/Fax

Practice location:
  • Phone: 304-355-2700
  • Fax: 304-355-8800
Mailing address:
  • Phone: 304-355-2700
  • Fax: 304-355-8800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberSP0552261
License Number StateWV

VIII. Authorized Official

Name: BRIDGETTE WEAVER
Title or Position: PHARMACY MANAGER
Credential: R.PH.
Phone: 304-355-2700