COUNTRY ROADS PHARMACY INC NPI 1093881898

NPI Information

  • NPI: 1093881898
  • Provider Name: COUNTRY ROADS PHARMACY INC
  • Classification: Pharmacist - 183500000X
  • Entity Type: Organization
  • Address: 109 BOLT RD
    GLEN DANIEL, WV
    ZIP 25844
  • Phone: (304) 934-5327

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NPI Details

COUNTRY ROADS PHARMACY INC is a pharmacist in Glen Daniel, WV. The provider is an individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. COUNTRY ROADS PHARMACY INC NPI is 1093881898. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

109 BOLT RD
GLEN DANIEL, WV
ZIP 25844-000
Phone: (304) 934-5327
Fax: (304) 934-5328

The provider's authorized official is Teresa Celene Thompson .
The authorized official title is Registered Pharmacist and has the following contact phone number (304) 934-5327.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)

The enumeration date for this NPI number is 11/27/2006 and was last updated on 2/24/2014.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1183500000XPharmacistSP0550106WEST VIRGINIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11140270001MEDICARE NSCWEST VIRGINIA
20139243000MEDICAIDWEST 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: 11/21/2025

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