Healthcare Provider Details

I. General information

NPI: 1497797724
Provider Name (Legal Business Name): MICHELS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 MAIN ST
WEST UNION WV
26456-2094
US

IV. Provider business mailing address

224 MAIN ST
WEST UNION WV
26456-2094
US

V. Phone/Fax

Practice location:
  • Phone: 304-873-1010
  • Fax: 304-973-2446
Mailing address:
  • Phone: 304-873-1010
  • Fax: 304-973-2446

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 NumberSP0550825
License Number StateWV

VIII. Authorized Official

Name: DANIEL ROCK
Title or Position: PRESIDENT
Credential:
Phone: 304-873-1010