NPIMap

Organization Active NPI

Clendenin Health Center Pharmacy at Riverview

  • Community/Retail Pharmacy
  • Clendenin, WV
National Provider Identifier
1285928804
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CLENDENIN HEALTH CENTER PHARMACY AT RIVERVIEW
Practice address
107 Koontz Ave
Clendenin, WV 25045
Phone
(304) 548-7272
Fax
(304) 548-7149
NPI assigned
May 31, 2011
Organization subpart
Yes
Parent organization
CABIN CREEK HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Angela Grace Stone, RPH
Title
Lead Pharmacist
Phone
(681) 205-8730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

107 Koontz Ave
Clendenin, WV 25045

Mailing address

104 Alex LN
Charleston, WV 25304-2952
Phone (304) 734-2040

Other identifiers 2

IdentifierTypeStateIssuer
3810021493MedicaidWV
MP0552393OtherWVPHARMACY LICENSE

Other names 1

  • Riverview Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kanawha City Health Center Pharmacy13 organizations share this tax ID, including this one
Part of
Kanawha City Health Center Pharmacy

Other organizations with this tax ID 12

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7267/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

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": "1306800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1285928804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ALEX LN",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042952",
            "telephone_number": "304-734-2040",
            "fax_number": "304-734-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 KOONTZ AVE",
            "city": "CLENDENIN",
            "state": "WV",
            "postal_code": "25045",
            "telephone_number": "304-548-7272",
            "fax_number": "304-548-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLENDENIN HEALTH CENTER PHARMACY AT RIVERVIEW",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CABIN CREEK HEALTH CENTER INC",
        "enumeration_date": "2011-05-31",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "LEAD PHARMACIST",
        "authorized_official_telephone_number": "681-205-8730",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810021493",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "MP0552393",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverview Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clendenin, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.