Healthcare Provider Details

I. General information

NPI: 1528085966
Provider Name (Legal Business Name): LOOP PLAZA PHARMACY CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 06/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 6TH AVE
SAINT ALBANS WV
25177-2769
US

IV. Provider business mailing address

PO BOX 480
SAINT ALBANS WV
25177-0480
US

V. Phone/Fax

Practice location:
  • Phone: 304-727-2233
  • Fax: 304-727-2299
Mailing address:
  • Phone: 304-727-2233
  • Fax: 304-727-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number011010
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number011010
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number011010
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number011010
License Number StateWV
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number011010
License Number StateWV
# 6
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number011010
License Number StateWV
# 7
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number011010
License Number StateWV
# 8
Primary TaxonomyN
Taxonomy Code3336N0007X
TaxonomyNuclear Pharmacy
License Number011010
License Number StateWV
# 9
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number011010
License Number StateWV

VIII. Authorized Official

Name: MR. WILLIAM STARRETT MCFARLAND
Title or Position: PRESIDENT
Credential: RPH
Phone: 304-727-2233