NPIMap

Organization Active NPI

Hurley Drug Co Inc

  • Community/Retail Pharmacy
  • Williamson, WV
National Provider Identifier
1750441960
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
SP0550134 Issued in WV
Legal business name
HURLEY DRUG CO INC
Practice address
210 Logan St
Williamson, WV 25661
Phone
(304) 235-3535
Fax
(304) 235-1258
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Authorized official

Name
Mrs. Nicole McNameeNPI 1962645960
Title
Owner
Phone
(304) 235-3535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X SP0550134 WV Primary
Compounding Pharmacy 3336C0004X SP0550134 WV
Home Infusion Therapy Pharmacy 3336H0001X SP0550134 WV

Addresses

Primary practice location

210 Logan St
Williamson, WV 25661

Mailing address

PO Box 220
Williamson, WV 25661-0220
Phone (304) 235-3535

Other identifiers 2

IdentifierTypeStateIssuer
0141986000MedicaidWV
5469002900MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091015000245 WV Part B Supplier - Mass Immunization (Roster Biller Only) 7012053465 Practice locations: Williamson, WV

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Hurley Drug Co Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1750441960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256610220",
            "telephone_number": "304-235-3535",
            "fax_number": "304-235-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LOGAN ST",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "25661",
            "telephone_number": "304-235-3535",
            "fax_number": "304-235-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURLEY DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "MCNAMEE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-235-3535",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0550134",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "WV",
            "license": "SP0550134",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "WV",
            "license": "SP0550134",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0141986000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5469002900",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamson, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.