Ravenswood Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

SP0552458 Issued in WV

Legal business name

RAVENSWOOD PHARMACY LLC

Practice address

408 Washington St
Ravenswood, WV 26164-1706

Phone

(304) 440-4410

Fax

(304) 440-4412

NPI assigned

Oct 11, 2013

Organization subpart

No

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

Authorized official

Name

Edward Zatta

Title

Owner

Phone

(740) 593-0204

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ravenswood Drug Doing business as

Locations

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

{
    "created_epoch": "1381449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1366879173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 WASHINGTON ST",
            "city": "RAVENSWOOD",
            "state": "WV",
            "postal_code": "261641706",
            "telephone_number": "304-440-4410",
            "fax_number": "304-440-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 WASHINGTON ST",
            "city": "RAVENSWOOD",
            "state": "WV",
            "postal_code": "261641706",
            "telephone_number": "304-440-4410",
            "fax_number": "304-440-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENSWOOD PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-11",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "ZATTA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-593-0204"
    },
    "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": "SP0552458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142481",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ravenswood Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marissa Kay Poorman, PHARMD
• Renea Pursley
• Quad/Med, LLC
• Kimberly Renee Rankin
• Ravenswood Family Medicine Ctr
• Ravenswood Village Opco, LLC
• Rex Allen Cummings Inc
• Corrie Lyn Runnion
• Michael Paul Rush
• Helen Dee Rymer, DDS

• Community/Retail Pharmacy in Ravenswood, WV
• Providers in Ravenswood, 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 Feb 24, 2017; 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.