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General NPI Number Information
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NPI Number | 1669657649
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Entity Type | Organization
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Legal Business Name | BARBOURSVILLE FAMILY PHARMACY
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 6007 US ROUTE 60 E SUITE 230
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-1042
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Country | US
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Telephone | 304-302-0564
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Fax |
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Provider Business Mailing Address
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Address Line | 6007 US ROUTE 60 E SUITE 230
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-1042
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Country | US
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Telephone | 304-302-0564
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. BRAC EMERY BROWN
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Credential | RPH
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Telephone | 304-204-2588
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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 | SP0552321
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License Number State | WV
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