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General NPI Number Information
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NPI Number | 1457427965
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Entity Type | Organization
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Legal Business Name | HUNTINGTON REGIONAL MEDICAL PARK PHARMACY INC
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 07/08/2014
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Provider Practice Location Address
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Address Line | 5170 ROUTE 60 E SUITE 2800
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City | HUNTINGTON
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State | WV
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Zip | 25705
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Country | US
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Telephone | 304-399-3784
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Fax | 304-399-3785
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Provider Business Mailing Address
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Address Line | PO BOX 999
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City | LAVALETTE
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State | WV
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Zip | 25535-0999
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Country | US
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Telephone | 304-529-3784
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Fax | 304-529-3785
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MICHELE DILLON
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Credential |
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Telephone | 304-399-3784
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | SP0552330
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License Number State | WV
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