Healthcare Provider Details

I. General information

NPI: 1023102746
Provider Name (Legal Business Name): HURLEY DRUG CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 LOGAN ST
WILLIAMSON WV
25661-3608
US

IV. Provider business mailing address

PO BOX 220
WILLIAMSON WV
25661-0220
US

V. Phone/Fax

Practice location:
  • Phone: 304-235-3535
  • Fax: 304-235-1258
Mailing address:
  • Phone: 304-235-3565
  • Fax: 304-235-1258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. TIM MCNAMEE
Title or Position: MANAGER/OWNER
Credential:
Phone: 304-235-3535