Healthcare Provider Details
I. General information
NPI: 1992882146
Provider Name (Legal Business Name): HURLEY DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CORNER OF 3RD AVE AND LOGAN ST
WILLIAMSON WV
25661
US
IV. Provider business mailing address
CORNER OF 3RD AVE AND LOGAN ST
WILLIAMSON WV
25661
US
V. Phone/Fax
- Phone: 304-235-3535
- Fax: 304-235-1258
- Phone: 304-235-3535
- Fax: 304-235-1258
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | SP0550134 |
| License Number State | WV |
VIII. Authorized Official
Name: MRS.
NICOLE
D
MCNAMEE
Title or Position: OWNER/PHARMACIST
Credential: PHARM D
Phone: 304-235-3535