Provider Demographics
NPI:1619051448
Name:GRIFFITH & FEIL DRUG, INC.
Entity Type:Organization
Organization Name:GRIFFITH & FEIL DRUG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:CISCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-453-2381
Mailing Address - Street 1:1405 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:KENOVA
Mailing Address - State:WV
Mailing Address - Zip Code:25530-1235
Mailing Address - Country:US
Mailing Address - Phone:304-453-2381
Mailing Address - Fax:304-453-1205
Practice Address - Street 1:1405 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:KENOVA
Practice Address - State:WV
Practice Address - Zip Code:25530-1235
Practice Address - Country:US
Practice Address - Phone:304-453-2381
Practice Address - Fax:304-453-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSP05501043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5002504OtherNCPDP
WV0141921000Medicaid
WV0141921000Medicaid