Healthcare Provider Details

I. General information

NPI: 1083617799
Provider Name (Legal Business Name): FOLLANSBEE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 COLLIERS WAY SUITE 204
WEIRTON WV
26062-5053
US

IV. Provider business mailing address

651 COLLIERS WAY SUITE 204
WEIRTON WV
26062-5053
US

V. Phone/Fax

Practice location:
  • Phone: 304-723-6331
  • Fax: 304-723-1131
Mailing address:
  • Phone: 304-723-6331
  • Fax: 304-723-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberSP0552308
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN JOSEPH BERNABEI
Title or Position: OWNER
Credential: RPH
Phone: 304-723-6331