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General NPI Number Information
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NPI Number | 1609432459
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Entity Type | Organization
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Legal Business Name | BRX LLC
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 319 S VIRGINIA AVE
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City | BRIDGEPORT
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State | WV
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Zip | 26330-1744
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Country | US
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Telephone | 304-842-7979
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Fax | 304-848-9797
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Provider Business Mailing Address
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Address Line | 38 LONE PINE DR
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City | MASONTOWN
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State | WV
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Zip | 26542-8604
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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 | MEMBER
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Name | ERIC B. BELLDINA
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Credential | RPH
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Telephone | 304-276-5066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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