BLACK DIAMOND PHARMACY LLC NPI 1558444026

NPI Information

  • NPI: 1558444026
  • Provider Name: BLACK DIAMOND PHARMACY, LLC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • CLIA Number: 51D1042228
  • Address: 33800 COAL HERITAGE ROAD
    NORTHFORK, WV
    ZIP 24868
  • Phone: (304) 862-2105

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NPI Details

BLACK DIAMOND PHARMACY, LLC is a community/retail pharmacy pharmacy in Northfork, 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. BLACK DIAMOND PHARMACY, LLC NPI is 1558444026. The provider is registered as an organization entity type.

The provider's business location address is:

33800 COAL HERITAGE ROAD
NORTHFORK, WV
ZIP 24868-397
Phone: (304) 862-2105
Fax: (304) 862-2107

The provider's authorized official is David Henry Dunson .
The authorized official title is Owner,manager and has the following contact phone number (304) 862-2105.

The CLIA number assigned to this NPI record is 51D1042228 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/20/2006 and was last updated on 3/7/2023.

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
13336C0003XPharmacyCommunity/Retail PharmacySP552244WEST 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
15011438OTHERWEST VIRGINIANABP
20008503000MEDICAIDWEST 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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