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CLAY SUPERMARKET INC

Pharmacy

Clay, West Virginia

Provider NPI: 1154491967

Organization Information:
Organization Name:  CLAY SUPERMARKET INC


Practice Location:
2200 MAIN ST  CLAY, WV 25043 US
Tel: 304-587-7327  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N333600000XSuppliers
Pharmacy
Y3336C0003XSuppliers
Pharmacy
WVSP0550942

Other Provider Identifiers:

IssuerNumberStateType
0144001000WV05
NCPDP PROVIDER IDENTIFICATION NUMBER500801301
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




PHARMACY JOBS WV - Page 1



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