Provider Demographics
NPI:1437291358
Name:FAS CHEK DISCOUNT PHARMACY
Entity Type:Organization
Organization Name:FAS CHEK DISCOUNT PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-988-1230
Mailing Address - Street 1:7703 SISSONVILLE DR
Mailing Address - Street 2:
Mailing Address - City:SISSONVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25320-9522
Mailing Address - Country:US
Mailing Address - Phone:304-988-1230
Mailing Address - Fax:304-988-1232
Practice Address - Street 1:7703 SISSONVILLE DR
Practice Address - Street 2:
Practice Address - City:SISSONVILLE
Practice Address - State:WV
Practice Address - Zip Code:25320-9522
Practice Address - Country:US
Practice Address - Phone:304-988-1230
Practice Address - Fax:304-988-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVMP0552308332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV6005103000Medicaid