MEDICARE: STUCK & ALGER 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	:	1235116641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STUCK & ALGER PHARMACY INC

Provider Business Mailing Address
First Line	:	PO BOX 427
Second Line	:	114 W WASHINGTON ST
City	:	CHARLES TOWN
State	:	WV
Zip	:	25414-0427
Country	:	US
Telephone Number	:	304-725-2621
Fax Number	:	304-728-4321

Provider Business Practice Location Address
First Line	:	114 W WASHINGTON ST
Second Line	:
City	:	CHARLES TOWN
State	:	WV
Zip	:	25414-1543
Country	:	US
Telephone Number	:	304-725-2621
Fax Number	:	304-728-4321

Authorized Official
Title or Position	:	PRESIDENT - PHARMACIST
Name	:	MR. PAUL RICHARD MANZUK
Credential	:	RPH
Telephone Number	:	304-725-2621

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	08/22/2020

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