Organization Name: | BIG FOUR DRUGSTORE INC |
NPI Number: | 1659358513 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN MARK ELLISON (PHARMACIST MANAGER) |
Mailing Address: | 300 Temple St Hinton |
State: | WV US |
Postal Code: | 259510688 |
Phone Number: | 3044662323 |
Fax Number: | 3044662366 |
NPI Enumeration Date: | 12/30/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | SP0550015 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WV |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |