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MAIN STREET PHARMACY INC NPI 1154625283


NPI Information

NPI: 1154625283
Provider Name: MAIN STREET PHARMACY INC

Doing Business As: STANAFORD INFUSION SERVICES

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 51D2235483

Address:
269 STANAFORD RD
SUITE B
BECKLEY, WV
ZIP 25801
Phone: (304) 860-1446
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MAIN STREET PHARMACY INC is an internal medicine in Beckley, WV. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. MAIN STREET PHARMACY INC NPI is 1154625283. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Stanaford Infusion Services.

The provider's business location address is:

269 STANAFORD RD
SUITE B
BECKLEY, WV
ZIP 25801-139
Phone: (304) 860-1446
Fax: (304) 894-8513

The provider's authorized official is Jawad Sherwani .
The authorized official title is Ceo and has the following contact phone number (304) 860-1446.

The CLIA number assigned to this NPI record is 51D2235483 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/4/2011 and was last updated on 7/14/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11154625283OTHERWEST VIRGINIABCBS
29393931MEDICARE UPINWEST VIRGINIA
33810019416MEDICAIDWEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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