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General NPI Number Information
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NPI Number | 1730012964
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Entity Type | Organization
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Legal Business Name | PRESTIGE PHARMACY L.L.C
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Dates
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Enumeration Date | 06/06/2026
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Last Update Date | 06/06/2026
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Provider Practice Location Address
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Address Line | 455 STANAFORD RD
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City | BECKLEY
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State | WV
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Zip | 25801-3145
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Country | US
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Telephone | 304-250-8922
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Fax |
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Provider Business Mailing Address
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Address Line | 455 STANAFORD RD
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City | BECKLEY
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State | WV
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Zip | 25801-3145
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Country | US
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Telephone | 304-250-8922
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. KHAJA MOHAMMED
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Credential | RPH
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Telephone | 304-250-8922
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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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