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General NPI Number Information
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NPI Number | 1912472069
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Entity Type | Organization
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Legal Business Name | LESTER SQUARE PHARMACY
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Dates
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Enumeration Date | 10/04/2018
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 837 ROBERT C BYRD DR
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City | SOPHIA
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State | WV
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Zip | 25921
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Country | US
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Telephone | 304-683-2111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 667
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City | BRADLEY
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State | WV
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Zip | 25818-0667
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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 | OWNER
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Name | MRS. MARGARET NJOKU
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Credential |
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Telephone | 304-237-1010
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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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