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NPI Code Detail

MEDICARE: FRUTH PHARMACY INC

MEDICARE: FRUTH 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
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyMP0552421WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12155004OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629078118
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRUTH PHARMACY INC
Provider Business Mailing Address
First Line : 4016 OHIO RIVER RD
Second Line :
City : POINT PLEASANT
State : WV
Zip : 25550-3257
Country : US
Telephone Number : 304-675-1612
Fax Number : 304-675-7905
Provider Business Practice Location Address
First Line : 511 MORRIS ST
Second Line :
City : CHARLESTON
State : WV
Zip : 25301-1326
Country : US
Telephone Number : 304-341-0257
Fax Number : 304-341-0557
Authorized Official
Title or Position : CEO
Name : ANDREW THOMAS BECKER
Credential :
Telephone Number : 304-675-1612
Provider Enumeration Date : 07/26/2005
Last Update Date : 09/29/2025

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Directions to “FRUTH PHARMACY INC ” Practice Location

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