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General NPI Number Information
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NPI Number | 1235432121
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Entity Type | Organization
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Legal Business Name | GOOD FAMILY PHARMACY, INC.
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 249 S PINCH RD
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City | ELKVIEW
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State | WV
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Zip | 25071-9376
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Country | US
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Telephone | 304-965-2456
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Fax |
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Provider Business Mailing Address
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Address Line | 249 S PINCH RD
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City | ELKVIEW
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State | WV
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Zip | 25071-9376
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Country | US
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Telephone | 304-965-2456
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Fax |
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. PATRICK JOSEPH GOOD
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Credential |
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Telephone | 304-965-2456
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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 | SP0552411
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License Number State | WV
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