Healthcare Provider Details

I. General information

NPI: 1932208824
Provider Name (Legal Business Name): WARDENSVILLE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 EAST MAIN ST
WARDENSVILLE WV
26851
US

IV. Provider business mailing address

PO BOX 425
WARDENSVILLE WV
26851-0425
US

V. Phone/Fax

Practice location:
  • Phone: 304-874-3687
  • Fax: 304-874-3692
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberSP0552191
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LISA WHETZEL
Title or Position: OWNER PHARMACIST
Credential: RPH
Phone: 304-874-3687