Healthcare Provider Details

I. General information

NPI: 1750441960
Provider Name (Legal Business Name): HURLEY DRUG CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 06/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 LOGAN ST
WILLIAMSON WV
25661
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: 304-235-3535
  • Fax: 304-235-1258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberSP0550134
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberSP0550134
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberSP0550134
License Number StateWV

VIII. Authorized Official

Name: MRS. NICOLE MCNAMEE
Title or Position: OWNER
Credential:
Phone: 304-235-3535