NPIMap

Organization Active NPI

Fruth Pharmacy Inc

  • Community/Retail Pharmacy
  • Spencer, WV
National Provider Identifier
1790790632
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
MP0551186 Issued in WV
Legal business name
FRUTH PHARMACY INC
Practice address
218 Market St
Spencer, WV 25276-1316
Phone
(304) 927-0011
Fax
(304) 891-2027
NPI assigned
Jul 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Andrew Becker
Title
Ceo
Phone
(304) 675-1612

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X MP0551186 WV Primary

Addresses

Primary practice location

218 Market St
Spencer, WV 25276-1316

Mailing address

Fruth Corporate Offices
4016 Ohio River Rd
Point Pleasant, WV 25550-2127
Phone (304) 675-1612

Other identifiers 3

IdentifierTypeStateIssuer
0227766009MedicaidWV
1790790632MedicaidWV
2111179OtherPK

Other names 1

  • FRUTH PHARMACY 18 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090724000389 WV Part B Supplier - Mass Immunization (Roster Biller Only) 3476606393 17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hurricane, WV; Milton, WV; Mineral Wells, WV; Nitro, WV; Point Pleasant, WV; Ripley, WV; Scott Depot, WV; Spencer, WV…

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

218 Market St
Spencer, WV 25276
Phone (304) 927-0011

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": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1790790632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FRUTH CORPORATE OFFICES",
            "address_2": "4016 OHIO RIVER RD",
            "city": "POINT PLEASANT",
            "state": "WV",
            "postal_code": "255502127",
            "telephone_number": "304-675-1612",
            "fax_number": "304-675-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 MARKET ST",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761316",
            "telephone_number": "304-927-0011",
            "fax_number": "304-891-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRUTH PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-675-1612"
    },
    "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": "MP0551186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0227766009",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790790632",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111179",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FRUTH PHARMACY 18",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spencer, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.