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General NPI Number Information
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NPI Number | 1174628408
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Entity Type | Organization
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Legal Business Name | THE MEDICINE CHEST PHARMACY INC OF WV
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6245 OHIO RIVER RD
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City | LESAGE
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State | WV
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Zip | 25537-9718
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Country | US
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Telephone | 304-736-8508
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Fax | 304-736-2806
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Provider Business Mailing Address
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Address Line | 6245 OHIO RIVER RD
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City | LESAGE
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State | WV
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Zip | 25537-9718
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GILBERT FULKS
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Credential | RPH
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Telephone | 304-736-8508
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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 | SP0550910
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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