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General NPI Number Information
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NPI Number | 1144327982
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Entity Type | Organization
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Legal Business Name | DISCOUNT EMPORIUM INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 3 MALL RD
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-1822
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Country | US
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Telephone | 304-736-2451
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Fax | 304-736-8519
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Provider Business Mailing Address
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Address Line | 1601 KANAWHA BLVD W SUITE 200
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City | CHARLESTON
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State | WV
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Zip | 25387-2539
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Country | US
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Telephone | 304-345-4836
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Fax | 304-345-4972
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Authorized Official
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Title or Position | V P PHARMACY
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Name | JERRY LEONARD
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Credential |
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Telephone | 304-345-4836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | MP0550012
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License Number State | WV
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