Provider Demographics
NPI:1447591581
Name:PENDLETON COMMUNITY CARE, INC
Entity Type:Organization
Organization Name:PENDLETON COMMUNITY CARE, INC
Other - Org Name:HARMAN PILL BOX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-358-2355
Mailing Address - Street 1:PO DRAWER 14
Mailing Address - Street 2:
Mailing Address - City:HARMAN
Mailing Address - State:WV
Mailing Address - Zip Code:26270-0014
Mailing Address - Country:US
Mailing Address - Phone:304-227-3661
Mailing Address - Fax:
Practice Address - Street 1:1 MOTT STREET
Practice Address - Street 2:
Practice Address - City:HARMAN
Practice Address - State:WV
Practice Address - Zip Code:26270-0000
Practice Address - Country:US
Practice Address - Phone:304-227-3661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy