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General NPI Number Information
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NPI Number | 1194839258
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Entity Type | Organization
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Legal Business Name | LOUCAS KARNOUPAKIS ENTERPRISES
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 11/15/2008
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Provider Practice Location Address
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Address Line | 265 PENCO RD
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City | WEIRTON
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State | WV
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Zip | 26062-3816
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Country | US
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Telephone | 304-723-2656
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Fax | 304-723-2657
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Provider Business Mailing Address
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Address Line | 265 PENCO RD
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City | WEIRTON
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State | WV
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Zip | 26062-3816
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Country | US
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Telephone | 304-723-2656
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Fax | 304-723-2657
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Authorized Official
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Title or Position | PIC
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Name | MR. THEODORE H. AMEREDES
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Credential | R.PH.
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Telephone | 304-723-2656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | MP0552293
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License Number State | WV
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