MEDICARE: FAMILY DISCOUNT PHARMACY INC

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	RP0004769	PA
2	332B00000X	Durable Medical Equipment & Medical Supplies

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

General Provider Information

NPI Number	:	1184628117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY DISCOUNT PHARMACY INC

Provider Business Mailing Address
First Line	:	PO BOX 1247
Second Line	:
City	:	MOUNT GAY
State	:	WV
Zip	:	25637-1247
Country	:	US
Telephone Number	:	304-752-1445
Fax Number	:	304-752-1468

Provider Business Practice Location Address
First Line	:	OLD RT 119
Second Line	:
City	:	MOUNT GAY
State	:	WV
Zip	:	25637-1247
Country	:	US
Telephone Number	:	304-752-1445
Fax Number	:	304-752-1468

Authorized Official
Title or Position	:	RPH
Name	:	MR. EARL CLAYCOMB
Credential	:	RPH
Telephone Number	:	304-752-1445

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	09/11/2025

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Directions to “FAMILY DISCOUNT PHARMACY INC ” Practice Location

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