MEDICARE: RPHV LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	MP0552314	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2111414	OTHER		PK

General Provider Information

NPI Number	:	1083780191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RPHV LLC

Provider Business Mailing Address
First Line	:	71 COWARDLY LION DR
Second Line	:
City	:	HEDGESVILLE
State	:	WV
Zip	:	25427-6785
Country	:	US
Telephone Number	:	304-754-5800
Fax Number	:	304-754-3400

Provider Business Practice Location Address
First Line	:	71 COWARDLY LION DR
Second Line	:
City	:	HEDGESVILLE
State	:	WV
Zip	:	25427-6785
Country	:	US
Telephone Number	:	304-754-5800
Fax Number	:	304-754-3400

Authorized Official
Title or Position	:	OFFICER
Name	:	MARK WILLIAMS
Credential	:	G
Telephone Number	:	304-754-5800

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	09/19/2025

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Directions to “RPHV LLC ” Practice Location

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