Provider Demographics
NPI:1750746046
Name:BECKLEY PHARMACY, INC.
Entity type:Organization
Organization Name:BECKLEY PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JAWED
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHERWANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-465-7200
Mailing Address - Street 1:455 STANAFORD RD
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3145
Mailing Address - Country:US
Mailing Address - Phone:304-256-1200
Mailing Address - Fax:304-256-8494
Practice Address - Street 1:455 STANAFORD RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3145
Practice Address - Country:US
Practice Address - Phone:304-256-1200
Practice Address - Fax:304-256-8494
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BECKLEY PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2245-72553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy