CITY PHARMACY (CITY PHARMACY) - NPI NUMBER 1043533003

Summary

Provider Name: CITY PHARMACY (CITY PHARMACY)

NPI Number: 1043533003

Clasification: Pharmacy (3336C0003X)

Specialization: Community/Retail Pharmacy

Address:
970 FOXCROFT AVE
SUITE 101
MARTINSBURG, WV
ZIP 25401

Phone Number: (304) 262-6555



Detailed Information

CITY PHARMACY is a community/retail pharmacy pharmacy in Martinsburg, WV. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. The assigned NPI number for this provider is 1043533003 and is registered as an organization entity type.
The provider Is Doing Business As City Pharmacy.

The provider's business address is:

970 FOXCROFT AVE
SUITE 101
MARTINSBURG, WV
ZIP 25401-835
Phone: (304) 262-6555
Fax: (304) 262-6599

The provider's authorized official is David M Wasanyi .
The authorized official title is Pharmacist and has the following contact phone number (540) 327-6140.

The enumeration date for this NPI number is 3/4/2010 and was last updated on 8/11/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 3336C0003X Pharmacy Community/Retail Pharmacy 27178989 WV Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 7128350001 MEDICARE NSC
2 3810017469 MEDICAID WV
3 FV96311 OTHER MEDICARE PTAN

NPI Record

No. Field Name Field Value
1 NPI 1043533003
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name CITY PHARMACY
5 Provider Other Organization Name CITY PHARMACY
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 970 FOXCROFT AVE
8 Provider Second Line Business Practice Location Address SUITE 101
9 Provider Business Practice Location Address City Name MARTINSBURG
10 Provider Business Practice Location Address State Name WV
11 Provider Business Practice Location Address Postal Code 254011835
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 3042626555
14 Provider Business Practice Location Address Fax Number 3042626599
15 Provider Enumeration Date 3/4/2010
16 Last Update Date 8/11/2014
17 Authorized Official Last Name WASANYI
18 Authorized Official First Name DAVID
19 Authorized Official Middle Name M
20 Authorized Official Title or Position PHARMACIST
21 Authorized Official Telephone Number 5403276140
22 Healthcare Provider Taxonomy Code 1 3336C0003X
23 Provider License Number 1 27178989
24 Provider License Number State Code 1 WV
25 Healthcare Provider Primary Taxonomy Switch 1 Y
26 Other Provider Identifier 1 7128350001
27 Other Provider Identifier Type Code 1 07
28 Other Provider Identifier 2 3810017469
29 Other Provider Identifier Type Code 2 05
30 Other Provider Identifier State 2 WV
31 Other Provider Identifier 3 FV96311
32 Other Provider Identifier Type Code 3 01
33 Other Provider Identifier Issuer 3 MEDICARE PTAN
34 Is Organization Subpart N
35 Authorized Official Name Prefix Text DR.
36 Authorized Official Credential Text PHARM.D

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This page was last updated on: 11/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.