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General NPI Number Information
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NPI Number | 1124471644
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Entity Type | Organization
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Legal Business Name | MARSHALL PHARMACY INC.
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 1600 MEDICAL CENTER DRIVE
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City | HUNTINGTON
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State | WV
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Zip | 25701-3655
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Country | US
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Telephone | 304-691-6879
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Fax | 304-205-1844
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Provider Business Mailing Address
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Address Line | 320 S. POLK STREET SUITE 800
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City | AMARILLO
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State | TX
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Zip | 79101-1429
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Country | US
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Telephone | 806-242-7782
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Fax | 806-324-5495
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Authorized Official
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Title or Position | SR. DIR. PHARMACY PAYER CONTRACTING
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Name | RYAN ATKINSON
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Credential |
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Telephone | 806-242-7782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | OP0552218
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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