Burnsville Drug Store

Primary specialty

PharmacyTaxonomy code 333600000X

License

6062 Issued in WV

Legal business name

BURNSVILLE DRUG STORE

Practice address

110 Municipal St
Burnsville, WV 26335

Phone

(304) 853-2500

Fax

(304) 853-2019

NPI assigned

Jan 18, 2007

Reactivated

Oct 9, 2007

Last updated

Sep 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David Michael McQuain

Title

Pharmacist

Phone

(304) 853-2500

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Burnsville Drug Store PLLC Former legal business name

Tax ID family

Antoine Katiny MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Antoine Katiny MD

  dba Braxton Imaging

  • Sonography Radiologic Technologist
  • Gassaway, WV
  • NPI 1922200773
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Antoine Katiny, MD

  • Internal Medicine Physician
  • Burnsville, WV
  • NPI 1407816416
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1225180136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 514",
            "address_2": "110 MUNICIPAL ST",
            "city": "BURNSVILLE",
            "state": "WV",
            "postal_code": "26335",
            "telephone_number": "304-853-2500",
            "fax_number": "304-853-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MUNICIPAL ST",
            "city": "BURNSVILLE",
            "state": "WV",
            "postal_code": "26335",
            "telephone_number": "304-853-2500",
            "fax_number": "304-853-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURNSVILLE DRUG STORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2014-09-11",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "MCQUAIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "304-853-2500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "6062",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WV",
            "license": "6062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8500041000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burnsville Drug Store PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kaitlyn Bollinger
• Burnsville Medical Center PLLC
• Community Care of West Virginia, Inc. (Burnsville Elementary School Wellness Center)
• Shadow Dobbins
• Kimberly Garrison
• Antoine Katiny, MD

• Pharmacy in Burnsville, WV
• Providers in Burnsville, WV by specialty
• Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.