Clay Supermarket Inc
Organization Active NPI Community/Retail Pharmacy · Clay, WV
NPI 1154491967 · NPPES record last updated Sep 10, 2009
Key facts
- NPI
- 1154491967
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- SP0550942 (WV)
- Legal business name
- CLAY SUPERMARKET INC
- Practice address
- 2200 Main St
Clay, WV 25043-0609 - Phone
- (304) 587-7327
- Fax
- (304) 587-4888
- NPI assigned
- Nov 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Dreama Clifton, RPH
- Title
- Owner
- Phone
- (304) 587-2777
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | SP0550942 | WV | Yes |
Addresses
Primary practice location
2200 Main St
Clay, WV 25043-0609
Mailing address
PO Box 609
Clay, WV 25043-0609
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5008013 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 0144001000 | Medicaid | WV |
Other names
- CLAY FOODLAND PHARMACY
Other providers in Clay, WV
- Clay County Health Department
- Clay County Schools
- Clay County Schools
- Clay Family Pharmacy LLC
- Clay Rural Medical Clinic PLLC
- Christopher Paul Claypool
- Drema Karroll Clifton
- Daniel Matthew Coleman
- Summer Paige Coleman
- Community Care of West Virginia
All providers in Clay, 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 10, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.