Organization Active NPI

Town & Country Drug Store Inc

  • Community/Retail Pharmacy
  • Stonewood, WV
National Provider Identifier
1518946276
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
TOWN & COUNTRY DRUG STORE INC
Practice address
8048 Water St
Stonewood, WV 26301-7709
Phone
(304) 624-5433
Fax
(304) 624-9343
NPI assigned
Jan 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Randy W. Williams, RPH
Title
RPH/Owner
Phone
(304) 624-5433

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X WV
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

8048 Water St
Stonewood, WV 26301-7709

Mailing address

8048 Water St
Stonewood, WV 26301-7709
Phone (304) 624-5433

Other identifiers 1

IdentifierTypeStateIssuer
0142329000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930025980 WV DME Supplier - Pharmacy 7719005438 Practice locations: Stonewood, WV
O20160229001254 WV Part B Supplier - Mass Immunization (Roster Biller Only) 7719005438 Practice locations: Stonewood, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D1041682Town and Country Drug Store8048 Water Street, Stonewood, WV 26301Certificate of waiverJun 8, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Town & Country Drug Store Inc8048 Water Street, Stonewood, WV 26301-7709(304) 624-5433 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Penile Pumps|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Nebulizer Equipment and/or Supplies|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 2005

National Provider Directory

National Provider Directory

Locations

8048 Water St
Stonewood, WV 26301
Phone (304) 624-5433

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1518946276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8048 WATER ST",
            "city": "STONEWOOD",
            "state": "WV",
            "postal_code": "263017709",
            "telephone_number": "304-624-5433",
            "fax_number": "304-624-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8048 WATER ST",
            "city": "STONEWOOD",
            "state": "WV",
            "postal_code": "263017709",
            "telephone_number": "304-624-5433",
            "fax_number": "304-624-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN & COUNTRY DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "RPH/OWNER",
        "authorized_official_telephone_number": "304-624-5433",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142329000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stonewood, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.