MEDICARE: SAFE RX PHARMACIES 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	3336C0003X	Community/Retail Pharmacy	SP0552295	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5012050	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1598846222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFE RX PHARMACIES INC

Provider Business Mailing Address
First Line	:	335 4TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-1223
Country	:	US
Telephone Number	:	304-522-0435
Fax Number	:	304-522-0437

Provider Business Practice Location Address
First Line	:	335 4TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-1223
Country	:	US
Telephone Number	:	304-522-0435
Fax Number	:	304-522-0437

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KENT FREEMAN
Credential	:
Telephone Number	:	740-377-4162

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	06/25/2009

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Directions to “SAFE RX PHARMACIES INC ” Practice Location

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