Crab Orchard Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

SP0552359 Issued in WV

Legal business name

CRAB ORCHARD PHARMACY INC

Doing business as

CRAB ORCHARD PHARMACY

Practice address

1299 Robert C Byrd Drive
Crab Orchard, WV 25827

Phone

(304) 253-7474

Fax

(304) 253-7495

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Richard Sallaz, RPHNPI 1730471343

Title

Owner/Pres/Pic

Phone

(304) 253-7474

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• CRAB ORCHARD PHARMACY 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 4

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

• Richard Sallaz, PHARM. D.

  • Pharmacist
  • Waynesboro, VA
  • NPI 1730471343
  NPD Authorized official
• Brandi Alexandra Keaton, PHARMACIST

  • Pharmacist
  • Beckley, WV
  • NPI 1063166783
  NPD (past)
• Alison Roark

  • Pharmacist
  • Crab Orchard, WV
  • NPI 1952914202
  NPD (past)
• Kathlyn Landis Sallaz, PHARMD

  • Pharmacist
  • Crab Orchard, WV
  • NPI 1891279576
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1619050754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "258270276",
            "telephone_number": "304-253-7474",
            "fax_number": "304-253-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 ROBERT C BYRD DRIVE",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "25827",
            "telephone_number": "304-253-7474",
            "fax_number": "304-253-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAB ORCHARD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "SALLAZ",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER/PRES/PIC",
        "authorized_official_telephone_number": "304-253-7474",
        "authorized_official_credential": "RPH"
    },
    "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": "SP0552359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139667000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2110661",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRAB ORCHARD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Lee Burleson, ARRT(R)(CT)
• Community Health Systems Inc
• Sarah Nicole Cooper, BSW, LSW
• Crab Orchard Medical Assoc. Inc.
• Crab Orchard Medical Assoc. Inc.
• Kayla Deane
• Stephanie Michelle Devaney
• Patricia Dixon
• Olen Jade Dodd, CRC
• Angela M Elkins, PA-C

• Community/Retail Pharmacy in Crab Orchard, WV
• Providers in Crab Orchard, 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 Feb 21, 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.