Charlie's Pharmacy of Mullens, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

CHARLIE'S PHARMACY OF MULLENS, LLC

Practice address

224 Howard Ave
Mullens, WV 25882-1421

Phone

(304) 294-5447

Fax

(304) 294-5314

NPI assigned

Aug 22, 2025

Last updated

Aug 22, 2025By 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

Kevin G Wilson, PHARM DNPI 1073258109

Title

Manager LLC

Phone

(304) 294-5447

Specialties & licenses 1

Addresses

Tax ID family

Charlie's Pharmacy of Mullens LLC2 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.

• Charlie's Pharmacy of Mullens, LLC

  • Community/Retail Pharmacy
  • Mullens, WV
  • NPI 1942499223
  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.

• Kevin G Wilson, PHARMD

  • Pharmacist
  • Mullens, WV
  • NPI 1073258109
  NPD Authorized official

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1396623898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "MULLENS",
            "state": "WV",
            "postal_code": "258820788",
            "telephone_number": "304-294-5447",
            "fax_number": "304-294-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 HOWARD AVE",
            "city": "MULLENS",
            "state": "WV",
            "postal_code": "258821421",
            "telephone_number": "304-294-5447",
            "fax_number": "304-294-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLIE'S PHARMACY OF MULLENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGER LLC",
        "authorized_official_telephone_number": "304-294-5447",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trina Carte
• Pamela Carter
• Tonia Carver
• Carol Chaffins
• Charles E. Porterfield
• Charlie's Pharmacy of Mullens, LLC
• Charlies Pharmacy Inc (Charlies Pharmacy)
• Cynthia Christian
• Lisa Christian
• City of Mullens

• Long Term Care Pharmacy in Mullens, WV
• Providers in Mullens, WV by specialty
• Long Term Care Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.