Healthcare Provider Details

I. General information

NPI: 1215009014
Provider Name (Legal Business Name): HOGE DAVIS DRUG CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 EAST BETHLEHEM BLVD
WHEELING WV
26003-4866
US

IV. Provider business mailing address

102 EAST BETHLEHEM BLVD
WHEELING WV
26003-4866
US

V. Phone/Fax

Practice location:
  • Phone: 304-242-1500
  • Fax: 304-242-6889
Mailing address:
  • Phone: 304-242-1500
  • Fax: 304-242-6889

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 NumberSP0550123
License Number StateWV

VIII. Authorized Official

Name: ANTHONY ANGELO MARTINO
Title or Position: PRESIDENT/PHARMACIST-IN-CHARGE
Credential: RPH.
Phone: 304-242-1500