Provider Demographics
NPI:1770639114
Name:G & R LLC
Entity Type:Organization
Organization Name:G & R LLC
Other - Org Name:BUDGET DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-697-5090
Mailing Address - Street 1:361 NORWAY AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-1320
Mailing Address - Country:US
Mailing Address - Phone:304-697-5090
Mailing Address - Fax:304-697-5091
Practice Address - Street 1:361 NORWAY AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-1320
Practice Address - Country:US
Practice Address - Phone:304-697-5090
Practice Address - Fax:304-697-5091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVMP05523253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5011793OtherNCPDP PROVIDER IDENTIFICATION NUMBER
WV6002003000Medicaid
3913880001Medicare NSC