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General NPI Number Information
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NPI Number | 1619333515
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Entity Type | Organization
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Legal Business Name | WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 2610 CAMDEN AVE
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City | PARKERSBURG
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State | WV
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Zip | 26101-5652
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Country | US
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Telephone | 304-917-3739
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Fax | 304-917-3751
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Provider Business Mailing Address
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Address Line | 2610 CAMDEN AVE
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City | PARKERSBURG
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State | WV
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Zip | 26101-5652
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Country | US
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Telephone | 304-917-3739
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Fax | 304-917-3751
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Authorized Official
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Title or Position | CEO
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Name | DEREK SNYDER
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Credential |
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Telephone | 304-275-8780
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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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | MP0552422
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License Number State | WV
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