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General NPI Number Information
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NPI Number | 1225775141
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Entity Type | Organization
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Legal Business Name | CHARLES TOWN PHARMACY
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Dates
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Enumeration Date | 05/13/2022
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 231 N SAMUEL ST
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City | CHARLES TOWN
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State | WV
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Zip | 25414-1839
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Country | US
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Telephone | 571-289-7664
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Fax |
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Provider Business Mailing Address
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Address Line | 231 N SAMUEL ST
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City | CHARLES TOWN
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State | WV
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Zip | 25414-1839
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Country | US
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Telephone | 571-289-7664
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANGER
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Name | EVON YOUSSEF
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Credential |
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Telephone | 571-289-7664
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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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