Provider Demographics
NPI:1093893240
Name:UNITED PHARMACY GROUP INC
Entity Type:Organization
Organization Name:UNITED PHARMACY GROUP INC
Other - Org Name:OCEANA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:NEBLETT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-682-8289
Mailing Address - Street 1:PO BOX 1800
Mailing Address - Street 2:
Mailing Address - City:OCEANA
Mailing Address - State:WV
Mailing Address - Zip Code:24870-1800
Mailing Address - Country:US
Mailing Address - Phone:304-682-8289
Mailing Address - Fax:304-682-4070
Practice Address - Street 1:928 COOK PARKWAY
Practice Address - Street 2:
Practice Address - City:OCEANA
Practice Address - State:WV
Practice Address - Zip Code:24870-1800
Practice Address - Country:US
Practice Address - Phone:304-682-8289
Practice Address - Fax:304-682-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0143962000Medicaid
WV0143962000Medicaid