Creighton Corporation

Primary specialty

PharmacyTaxonomy code 333600000X

License

MP0552345 Issued in WV

Legal business name

CREIGHTON CORPORATION

Doing business as

Moundsville IGA Pharmacy

Practice address

200 Lafayette Ave
Moundsville, WV 26041-1001

Phone

(304) 843-0040

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Richard Mollenkopf

Title

Manager

Phone

(304) 612-3115

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Moundsville IGA Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1417176041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LAFAYETTE AVE",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260411001",
            "telephone_number": "304-843-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LAFAYETTE AVE",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260411001",
            "telephone_number": "304-843-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREIGHTON CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "MOLLENKOPF",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "304-612-3115",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WV",
            "license": "MP0552345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "NCPDP",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moundsville IGA Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura L Coss
• Dawn Marie Courtwright
• Donna Cox
• Teresha Ann Craft
• Denise Ann Cramer
• Nancy J Crews
• April G Crihfield
• Carrie Jo Cross, RN
• Jennifer Crow
• Sheila Ruth Crow

• Pharmacy in Moundsville, WV
• Providers in Moundsville, WV by specialty
• Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.