Bypass Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

SP0552433 Issued in WV

Legal business name

BYPASS PHARMACY INC

Doing business as

BYPASS PHARMACY # 2

Practice address

725 Ritter Dr FL 1
Glen Morgan, WV 25813-7709

Phone

(304) 252-3000

Fax

(304) 252-8212

NPI assigned

Jul 27, 2012

Organization subpart

No

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

Authorized official

Name

Siddarthan Ilangovan

Title

President

Phone

(304) 222-3064

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• BYPASS PHARMACY # 2 Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Bypass Pharmacy, Inc

  • Community/Retail Pharmacy
  • Beckley, WV
  • NPI 1760793772

  Member Of

  NPD member

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1497001499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014930",
            "telephone_number": "304-222-3064",
            "fax_number": "304-253-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RITTER DR FL 1",
            "city": "GLEN MORGAN",
            "state": "WV",
            "postal_code": "258137709",
            "telephone_number": "304-252-3000",
            "fax_number": "304-252-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BYPASS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "ILANGOVAN",
        "authorized_official_first_name": "SIDDARTHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-222-3064"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0552433",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136181",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BYPASS PHARMACY # 2",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BYPASS PHARMACY # 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Elizabeth Boyd
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• Prudencio C Corro, MD
• Samantha Cozart
• Regina Lynn Croto
• Ann Darby

• Community/Retail Pharmacy in Glen Morgan, WV
• Providers in Glen Morgan, 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 Nov 18, 2021; 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.