CMC Pharmacy, LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

SP0552442 Issued in WV

Legal business name

CMC PHARMACY, LLC

Practice address

3100 Maccorkle Ave SE
Suite 100
Charleston, WV 25304-1223

Phone

(304) 344-8021

Fax

(304) 344-0655

NPI assigned

Sep 8, 2016

Organization subpart

Yes

Parent organization

ELWYN PHARMACY GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Nicholas Karalis

Title

Ceo & President

Phone

(610) 545-6040

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 2

• BioMatrix Specialty Pharmacy WV Doing business as
• Med Center Specialty Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1124575907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE",
            "address_2": "SUITE 100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-344-8021",
            "fax_number": "304-344-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE",
            "address_2": "SUITE 100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-344-8021",
            "fax_number": "304-344-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC PHARMACY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELWYN PHARMACY GROUP, LLC",
        "enumeration_date": "2016-09-08",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "KARALIS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CEO & PRESIDENT",
        "authorized_official_telephone_number": "610-545-6040"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0552442",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "WV",
            "license": "SP0552442",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810025009",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BioMatrix Specialty Pharmacy WV",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Center Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Center Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly A Cloonan, PH.D.
• Ashley Clowers
• Kayla Clutter
• Heavenly Faith Clyburn
• Victoria Nicole Brooke Clyburn
• CMC Pharmacy, LLC
• Cheyenne Coakley
• Coal Mountain Laboratory
• Brandee Nichole Coalson, COTA/L
• Jessica Coates

• Home Infusion Therapy Pharmacy in Charleston, WV
• Providers in Charleston, WV by specialty
• Home Infusion Therapy Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.