Organization Active NPI

Charles Town Pharmacy

  • Pharmacy
  • Charles Town, WV
National Provider Identifier
1225775141
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
CHARLES TOWN PHARMACY
Practice address
231 N Samuel St
Charles Town, WV 25414-1839
Phone
(571) 289-7664
NPI assigned
May 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Authorized official

Name
Evon YoussefNPI 1235734658
Title
Pharmacy Manger
Phone
(571) 289-7664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

231 N Samuel St
Charles Town, WV 25414-1839

Mailing address

231 N Samuel St
Charles Town, WV 25414-1839
Phone (571) 289-7664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220809000320 WV Part B Supplier - Pharmacy 9537541446 Practice locations: Charles Town, WV

National Provider Directory

National Provider Directory

Locations

231 N Samuel St
Charles Town, WV 25414
Phone (571) 289-7664

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1225775141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 N SAMUEL ST",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254141839",
            "telephone_number": "571-289-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 N SAMUEL ST",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254141839",
            "telephone_number": "571-289-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES TOWN PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "YOUSSEF",
        "authorized_official_first_name": "EVON",
        "authorized_official_title_or_position": "PHARMACY MANGER",
        "authorized_official_telephone_number": "571-289-7664"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles Town, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.