Goodykoontz Drug Store Inc

LBN: Goodykoontz Drug Stores Inc
Goodykoontz Drug Store Inc is an health care organization with primary practice located at 2924 East Cumberland Road , Bluefield WV 24701. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Goodykoontz Drug Stores Inc can be contacted via phone (304) 325-7121, or through Bovenizer, Jerry via phone (304) 324-7601.

Contact Information

Primary practice address
2924 East Cumberland Road Bluefield WV 24701
Phone: (304) 325-7121
Fax: (304) 327-9701
Website:
Map and Directions
Authorized official contact:
Name: Bovenizer, Jerry RPH
Phone: (304) 324-7601

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X SP0550098 West Virginia
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1417054255
LBN Legal business name Goodykoontz Drug Stores Inc
DBA Doing business as Goodykoontz Drug Store Inc
Authorized official Bovenizer, Jerry RPH
Entity Organization
Organization subpart 1 No
Enumeration date Sep 20th, 2006
Last updated Sep 19th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417054255 NPPES
Virginia MEDICAID 0085046995
Virginia MEDICAID 0141899000
Virginia Other 2109351

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