Clendenin Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

SP0550759 Issued in WV

Legal business name

CLENDENIN PHARMACY INC

Doing business as

Clendenin Pharmacy Inc

Practice address

10 Main St
Clendenin, WV 25045

Phone

(304) 548-5451

Fax

(304) 548-5765

NPI assigned

Dec 27, 2006

Last updated

Jan 18, 2017By 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

William Ore, RPHNPI 1013012806

Title

Pres

Phone

(304) 548-5451

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• CLENDENIN PHARMACY INC Doing business as

Medicare fee-for-service enrollment

Enrolled in WV2 enrollments

Enrollment records 2

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

Medicare medical equipment & supply locations

Practitioners 3

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.

• William J. Ore, R. PH.

  • Pharmacist
  • Clendenin, WV
  • NPI 1013012806
  NPD Authorized official
• Lindsay A Matuszkiewicz, PHARMD

  • Pharmacist
  • Clendenin, WV
  • NPI 1750681011
  NPD
• Sara Brook Goff

  • Pharmacist
  • Clendenin, WV
  • NPI 1982311775
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1609931732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 698",
            "city": "CLENDENIN",
            "state": "WV",
            "postal_code": "250450698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MAIN ST",
            "city": "CLENDENIN",
            "state": "WV",
            "postal_code": "25045",
            "telephone_number": "304-548-5451",
            "fax_number": "304-548-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLENDENIN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "ORE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "304-548-5451",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0550759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0143182000A",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2109367",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLENDENIN PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanaya Burdette, RN
• Cabin Creek Health Center, Inc. (Clendenin Health Center)
• Amanda Marie Canipe, PHARM D
• Clendenin Health Center Lab
• Clendenin Health Center Pharmacy at Riverview (Riverview Pharmacy)
• Tammie Ann Cummings
• Cynthia Derringer
• Douglas Joseph Donovall Jr., PHARM. D.
• Kerry Drabish, FNP-BC
• Chari Dove Eggleton

• Community/Retail Pharmacy in Clendenin, WV
• Providers in Clendenin, 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 Jan 18, 2017; 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.