Waterfront Family Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

SP0552324 Issued in WV

Legal business name

WATERFRONT FAMILY PHARMACY LLC

Doing business as

WATERFRONT FAMILY PHARMACY

Practice address

215 Don Knotts Blvd
Ste 120
Morgantown, WV 26501-0113

Phone

(304) 225-7979

Fax

(304) 225-3784

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Rachael Hudson, RPH

Title

Co Owner and Pharm

Phone

(304) 225-7979

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• WATERFRONT FAMILY 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.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 5

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

• Kelsi Hines, PHARMD

  • Pharmacist
  • Morgantown, WV
  • NPI 1649757246
  NPD (past)
• Rachel Ann Snyder, RPH

  • Pharmacist
  • Morgantown, WV
  • NPI 1063990091
  NPD (past)
• Katherine Elizabeth Vecchio, RPH

  • Pharmacist
  • Morgantown, WV
  • NPI 1891357562
  NPD (past)
• Jessica Hinson, PHARMD

  • Pharmacist
  • Ada, OH
  • NPI 1578962551
  NPD (past)
• Connor Rowan, PHARMD

  • Pharmacist
  • Seattle, WA
  • NPI 1629741806
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1629099684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 DON KNOTTS BLVD",
            "address_2": "STE 120",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265010113",
            "telephone_number": "304-225-7979",
            "fax_number": "304-225-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 DON KNOTTS BLVD",
            "address_2": "STE 120",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265010113",
            "telephone_number": "304-225-7979",
            "fax_number": "304-225-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFRONT FAMILY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_title_or_position": "CO OWNER AND PHARM",
        "authorized_official_telephone_number": "304-225-7979",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0552324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004619",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111571",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WATERFRONT FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brad Washburn, CPC, CHT
• Jamara Washington
• Keirstin Washington
• Usha Glory Wasilefsky, DO
• Waterfront Diabetes Education Center
• Waterfront Urgent Care PLLC
• Kasandra Waters
• Kristie Waters
• Lucille Tedesco Waters, MS,CCC/SLP
• Colleen M Watkins, M. D.

• Community/Retail Pharmacy in Morgantown, WV
• Providers in Morgantown, 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 Jun 1, 2016; 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.