Mountaineer Medical Pharmacy LLC
NPI #1134569668 in Bridgeport, West Virginia
Provider Information
- NPI Number
- 1134569668
- Entity Type
- Organization
- Organization Name
- Mountaineer Medical Pharmacy LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jun 28, 2013
- Last Updated
- Oct 26, 2013
Practice Location
- Address
- 120 MEDICAL PARK DR STE 102
- City
- Bridgeport
- State
- West Virginia
- ZIP Code
- 26330-9013
- Phone
- (304) 423-5200
Authorized Official
- Name
- MICHAEL KOVACK
- Title
- PHARM MGR
- Phone
- (304) 423-5000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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