Med-Mart Pharmacy LLC
NPI #1386131050 in Fairmont, West Virginia
Provider Information
- NPI Number
- 1386131050
- Entity Type
- Organization
- Organization Name
- Med-Mart Pharmacy LLC
- Primary Specialty
- Pharmacy
- Enumeration Date
- Apr 18, 2018
- Last Updated
- Dec 11, 2019
Practice Location
- Address
- 181 MIDDLETOWN CIR
- City
- Fairmont
- State
- West Virginia
- ZIP Code
- 26554-2015
- Phone
- (304) 367-9122
Authorized Official
- Name
- IBRAHIM KADDOURAH
- Title
- OWNER/PIC
- Phone
- (304) 367-9122
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
| Pharmacy |
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