Healthcare Provider Details
I. General information
NPI: 1871538082
Provider Name (Legal Business Name): AMERICAN PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 FAIRMONT AVE
WHITE HALL WV
26554-3451
US
IV. Provider business mailing address
1022 RIVERVIEW DR
FAIRMONT WV
26554-8308
US
V. Phone/Fax
- Phone: 304-368-9123
- Fax: 304-368-9451
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | SP0552259 |
| License Number State | WV |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JANETTE
CELLAND
Title or Position: MANAGING MEMBER
Credential:
Phone: 304-368-9123