NPIMap

Organization Active NPI

Community Care of West Virginia, Inc.

Doing business as Community Care Pharmacy of Weston

  • Pharmacy
  • Weston, WV
National Provider Identifier
1184022428
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
SPO552482 Issued in WV
Legal business name
COMMUNITY CARE OF WEST VIRGINIA, INC.
Doing business as
Community Care Pharmacy of Weston
Practice address
107 Staunton Dr
Weston, WV 26452
Phone
(304) 269-9555
Fax
(304) 269-8409
NPI assigned
Dec 19, 2014
Last updated
Feb 13, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY CARE OF WEST VIRGINIA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Authorized official

Name
Mr. Richard G. Simon
Title
Ceo
Phone
(304) 924-6262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X SPO552482 WV Primary

Addresses

Primary practice location

107 Staunton Dr
Weston, WV 26452

Mailing address

107 Staunton Dr
Weston, WV 26452-5604
Phone (304) 269-9555

Other practice location 1

597 Liberty Street
West Milford, WV 26451
Phone (304) 745-3000

Other practice location 2

107 Staunton Dr
Weston, WV 26452
Phone (304) 269-9555

Other names 1

  • Community Care Pharmacy of Weston Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Care of West Virginia19 organizations share this tax ID, including this one
Part of
Community Care of West Virginia

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1418947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550016000000",
    "number": "1184022428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 STAUNTON DR",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264525604",
            "telephone_number": "304-269-9555",
            "fax_number": "304-269-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 STAUNTON DR",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "26452",
            "telephone_number": "304-269-9555",
            "fax_number": "304-269-8409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "597 Liberty Street",
            "address_purpose": "LOCATION",
            "city": "West Milford",
            "state": "WV",
            "postal_code": "26451",
            "country_code": "US",
            "telephone_number": "304-745-3000",
            "fax_number": "304-745-3022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 Staunton Dr",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "WV",
            "postal_code": "26452",
            "country_code": "US",
            "telephone_number": "304-269-9555",
            "fax_number": "304-269-8409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY CARE OF WEST VIRGINIA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CARE OF WEST VIRGINIA, INC.",
        "enumeration_date": "2014-12-19",
        "last_updated": "2019-02-13",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-924-6262",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WV",
            "license": "SPO552482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Pharmacy of Weston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; 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.