Provider Demographics
NPI:1932186780
Name:INHOME MEDICATIONS WV, INC
Entity Type:Organization
Organization Name:INHOME MEDICATIONS WV, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P.
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-698-3737
Mailing Address - Street 1:201 S PRESTON ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-1628
Mailing Address - Country:US
Mailing Address - Phone:304-725-3509
Mailing Address - Fax:304-728-6946
Practice Address - Street 1:201 S PRESTON ST
Practice Address - Street 2:SUITE C
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-1628
Practice Address - Country:US
Practice Address - Phone:304-725-3509
Practice Address - Fax:304-728-6946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVMP0551276333600000X
VA0214000228333600000X
OH02193333600000X
ARX01570333600000X
NC07117333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2011174Medicaid
VA9115871Medicaid
AR138694741Medicaid
WV0141491000Medicaid
AR138694741Medicaid