NPIMap

Organization Active NPI

White Hall Pharmacy LLC

  • Community/Retail Pharmacy
  • Fairmont, WV
National Provider Identifier
1114098134
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
SP0552374 Issued in WV
Legal business name
WHITE HALL PHARMACY LLC
Doing business as
White Hall Pharmacy LLC
Practice address
1325 Locust Ave
Fairmont, WV 26554-1435
Phone
(304) 368-9355
Fax
(304) 367-8601
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Terri Vilain, RPH
Title
Owner
Phone
(304) 368-9355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X SP0552374 WV Primary

Addresses

Primary practice location

1325 Locust Ave
Fairmont, WV 26554-1435

Mailing address

1325 Locust Ave
Fairmont, WV 26554-1435
Phone (304) 368-9355

Other identifiers 2

IdentifierTypeStateIssuer
5010905OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3810012153MedicaidWV

Other names 1

  • WHITE HALL PHARMACY LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
White Hall Pharmacy LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1114098134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541435",
            "telephone_number": "304-368-9355",
            "fax_number": "304-367-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541435",
            "telephone_number": "304-368-9355",
            "fax_number": "304-367-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE HALL PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "VILAIN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-368-9355",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0552374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5010905",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810012153",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WHITE HALL PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.