Main Street Pharmacy Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MAIN STREET PHARMACY INC

Practice address

269 Stanaford Rd
Suite B
Beckley, WV 25801-3139

Phone

(304) 860-1446

Fax

(304) 894-8513

NPI assigned

Jan 4, 2011

Organization subpart

Yes

Parent organization

MAIN STREET PHARMACY, INCAs reported in NPPES

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

Authorized official

Name

Jawad Sherwani

Title

Ceo

Phone

(304) 860-1446

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Stanaford Infusion Services Doing business as

Part of

Main Street Pharmacy Inc

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robin Lynn Chianumba, FNP

  • Family Nurse Practitioner
  • Beckley, WV
  • NPI 1427142660
  NPD (past)

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1154625283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 STANAFORD RD",
            "address_2": "SUITE B",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013139",
            "telephone_number": "304-860-1446",
            "fax_number": "304-894-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 STANAFORD RD",
            "address_2": "SUITE B",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013139",
            "telephone_number": "304-860-1446",
            "fax_number": "304-894-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAIN STREET PHARMACY, INC",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "SHERWANI",
        "authorized_official_first_name": "JAWAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-860-1446"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810019416",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1154625283",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanaford Infusion Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andy Macdonald
• Ryan Macdonald
• Nicole Mackay
• Tanya Ann Maddy, NP-C
• Richard J Mailloux, MD
• Daniel Joseph Mainello, LPC
• Joan Maiolo
• Joseph A Maiolo, M.D.
• Lyndsey Maiolo
• Tina Maiolo

• Internal Medicine Physician in Beckley, WV
• Providers in Beckley, WV by specialty
• Internal Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.