Healthcare Provider Details

I. General information

NPI: 1124030366
Provider Name (Legal Business Name): ANILE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 05/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2413 PENNSYLVANIA AVE
WEIRTON WV
26062-3632
US

IV. Provider business mailing address

2413 PENNSYLVANIA AVE
WEIRTON WV
26062-3632
US

V. Phone/Fax

Practice location:
  • Phone: 304-723-1818
  • Fax:
Mailing address:
  • Phone: 304-723-1818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberSP0550004
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DIANA SIKORA
Title or Position: PIC AND COOWNER
Credential: RPH
Phone: 304-723-1818