MEDICARE: PHILLIPS 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

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	:	1225037260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILLIPS PHARMACY INC.

Provider Business Mailing Address
First Line	:	PO BOX 1
Second Line	:
City	:	SAINT MARYS
State	:	WV
Zip	:	26170-0001
Country	:	US
Telephone Number	:	304-684-3784
Fax Number	:	304-684-2358

Provider Business Practice Location Address
First Line	:	329 2ND ST
Second Line	:
City	:	SAINT MARYS
State	:	WV
Zip	:	26170-1005
Country	:	US
Telephone Number	:	304-684-3784
Fax Number	:	304-684-2358

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	TROY WINLAND
Credential	:
Telephone Number	:	304-684-3888

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	03/03/2022

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Directions to “PHILLIPS PHARMACY INC. ” Practice Location

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