Lumberport Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

MP0552539 Issued in WV

Legal business name

LUMBERPORT PHARMACY, INC

Doing business as

Lumberport Pharmacy, Inc.

Practice address

308 Main Street
Lumberport, WV 26386

Phone

(740) 452-7655

Fax

(740) 452-7655

NPI assigned

Sep 27, 2005

Last updated

Apr 2, 2020By 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

John Coler

Title

Owner/Manager/Ao

Phone

(740) 452-7685

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Lumberport Pharmacy, Inc. Doing business as

Locations

Practitioners 2

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.

• Carol McKisic, RPH

  • Pharmacist
  • Lumberport, WV
  • NPI 1477855302
  NPD (past)
• Susan P Meredith, R.PH.

  • Pharmacist
  • Lumberport, WV
  • NPI 1265734073
  NPD (past)

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1326034141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3506",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437023506",
            "telephone_number": "740-452-7685",
            "fax_number": "740-452-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 MAIN STREET",
            "city": "LUMBERPORT",
            "state": "WV",
            "postal_code": "26386",
            "telephone_number": "740-452-7655",
            "fax_number": "740-452-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMBERPORT PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "COLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/MANAGER/AO",
        "authorized_official_telephone_number": "740-452-7685"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "MP0552539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326034141",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Q620870001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lumberport Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marjorie Heldreth
• Pamela Sue Higginbotham
• Savannah Leighann Holt
• Alyssa Losh
• Glenda D Lucas
• Brenda McDaniel
• Austin Michael McIntyre
• Carol McKisic, RPH
• Susan P Meredith, R.PH.
• Tammy Joan Miller

• Community/Retail Pharmacy in Lumberport, WV
• Providers in Lumberport, WV by specialty
• Community/Retail Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.