MEDICARE: RED DOT 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	RP0003726	WV
2	333600000X	Pharmacy	RP0002474	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

General Provider Information

NPI Number	:	1225014574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RED DOT PHARMACY INC

Provider Business Mailing Address
First Line	:	131 MARKET ST
Second Line	:
City	:	MANNINGTON
State	:	WV
Zip	:	26582-1130
Country	:	US
Telephone Number	:	304-986-3486
Fax Number	:	304-986-1785

Provider Business Practice Location Address
First Line	:	131 MARKET ST
Second Line	:
City	:	MANNINGTON
State	:	WV
Zip	:	26582-1130
Country	:	US
Telephone Number	:	304-986-3486
Fax Number	:	304-986-1785

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. MARK E MORRIS
Credential	:
Telephone Number	:	304-986-3486

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	08/22/2020

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Directions to “RED DOT PHARMACY INC ” Practice Location

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