Healthcare Provider Details

I. General information

NPI: 1932186780
Provider Name (Legal Business Name): INHOME MEDICATIONS WV, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 04/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S PRESTON ST SUITE C
RANSON WV
25438-1628
US

IV. Provider business mailing address

201 S PRESTON ST SUITE C
RANSON WV
25438-1628
US

V. Phone/Fax

Practice location:
  • Phone: 304-725-3509
  • Fax: 304-728-6946
Mailing address:
  • Phone: 304-725-3509
  • Fax: 304-728-6946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0214000228
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number02193
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberX01570
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number07117
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberMP0551276
License Number StateWV

VIII. Authorized Official

Name: MRS. PATRICIA LONG
Title or Position: V.P.
Credential:
Phone: 386-698-3737