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WATERFRONT FAMILY PHARMACY LLC NPI 1629099684


NPI Information

NPI: 1629099684
Provider Name: WATERFRONT FAMILY PHARMACY LLC

Doing Business As: WATERFRONT FAMILY PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 51D2091405

Address:
215 DON KNOTTS BLVD
STE 120
MORGANTOWN, WV
ZIP 26501
Phone: (304) 225-7979
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WATERFRONT FAMILY PHARMACY LLC is a community/retail pharmacy pharmacy in Morgantown, 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. WATERFRONT FAMILY PHARMACY LLC NPI is 1629099684. The provider is registered as an organization entity type.
The provider Is Doing Business As Waterfront Family Pharmacy.

The provider's business location address is:

215 DON KNOTTS BLVD
STE 120
MORGANTOWN, WV
ZIP 26501-113
Phone: (304) 225-7979
Fax: (304) 225-3784

The provider's authorized official is Rachael Hudson .
The authorized official title is Co Owner And Pharm and has the following contact phone number (304) 225-7979.

The CLIA number assigned to this NPI record is 51D2091405 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/22/2006 and was last updated on 6/1/2016.


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
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacySP0552324WEST 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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12111571OTHERPK
25654040001MEDICARE NSC
33810004619MEDICAIDWEST 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

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.