Fruth Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Charleston, WV
NPI 1073528915 · NPPES record last updated Sep 29, 2025
Key facts
- NPI
- 1073528915
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 0550187 (WV)
- Legal business name
- FRUTH PHARMACY INC
- Practice address
- 864 Oakwood Rd
Charleston, WV 25314-2010 - Phone
- (304) 343-2807
- Fax
- (304) 720-3218
- NPI assigned
- Jul 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Andrew Becker
- Title
- Ceo
- Phone
- (304) 675-1612
Other NPIs on the same Medicare enrollment 11
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D1005634 | Fruth Pharmacy 14 | Certificate of waiver | Oct 27, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090724000389 | WV | Part B Supplier - Mass Immunization (Roster Biller Only) | 3476606393 |
17 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hurricane, WV; Milton, WV; Mineral Wells, WV; Nitro, WV; Point Pleasant, WV; Ripley, WV; Scott Depot, WV; Spencer, WV… |
National Provider Directory
Locations
864 Oakwood Rd
Charleston, WV 25314
Phone (304) 343-2807
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 0550187 | WV | Yes |
Addresses
Primary practice location
864 Oakwood Rd
Charleston, WV 25314-2010
Mailing address
Fruth Corporate Offices
4016 Ohio River Rd
West Virginia, WV 25550-2127
Phone (304) 675-1612
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0227766006 | Medicaid | WV | |
| 1073528915 | Medicaid | WV | |
| 2110644 | Other | PK |
Other names
- FRUTH PHARMACY 14
Other providers in Charleston, WV
- John G Frohna
- Ashley Fronda
- Dana Frost
- Deborah Suzanne Frost
- Tina Frost
- Fruth Pharmacy Inc
- Fruth Pharmacy Inc
- Joan Fry
- Lois Fry
- Carolyn S Frye
All providers in Charleston, WV · Community/Retail Pharmacy in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.