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General NPI Number Information
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NPI Number | 1750726444
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Entity Type | Organization
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Legal Business Name | KANAWHA CITY HEALTH CENTER PHARMACY
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 4602 MACCORKLE AVE SE
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City | CHARLESTON
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State | WV
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Zip | 25304-1848
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Country | US
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Telephone | 304-205-7534
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Fax | 304-205-7548
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Provider Business Mailing Address
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Address Line | 104 ALEX LN
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City | CHARLESTON
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State | WV
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Zip | 25304-2952
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Country | US
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Telephone | 304-734-2040
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Fax | 304-734-2047
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Authorized Official
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Title or Position | LEAD PHARMACIST
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Name | ANGELA GRACE STONE
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Credential | RPH
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Telephone | 681-205-8730
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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 | SP0552477
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License Number State | WV
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