Provider Demographics
NPI:1780483693
Name:R. CHAFFIN DRUG CO., LLC
Entity type:Organization
Organization Name:R. CHAFFIN DRUG CO., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:BERRY
Authorized Official - Last Name:CHAFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:606-534-0701
Mailing Address - Street 1:140 OLD BELL RD
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:WV
Mailing Address - Zip Code:24925-7613
Mailing Address - Country:US
Mailing Address - Phone:681-214-7774
Mailing Address - Fax:
Practice Address - Street 1:8468 SENECA TRL S
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-9626
Practice Address - Country:US
Practice Address - Phone:681-214-7774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy