NPIMap

Organization Active NPI

Sissonville Health Center Pharmacy

  • Community/Retail Pharmacy
  • Charleston, WV
National Provider Identifier
1851843965
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SISSONVILLE HEALTH CENTER PHARMACY
Doing business as
Sissonville Health Center Pharmacy
Practice address
6135 Sissonville Dr
Charleston, WV 25312-9444
Phone
(304) 343-8030
Fax
(304) 343-8031
NPI assigned
Oct 25, 2016
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CABIN CREEK HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Angela Grace Stone, RPH
Title
Lead Pharmacist
Phone
(681) 205-8730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

6135 Sissonville Dr
Charleston, WV 25312-9444

Mailing address

104 Alex LN
Charleston, WV 25304-2952
Phone (304) 734-2040

Other identifiers 2

IdentifierTypeStateIssuer
1851843965MedicaidWV
2170333OtherPK

Other names 1

  • Sissonville Health Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cabin Creek Health Center Pharmacy13 organizations share this tax ID, including this one
Part of
Cabin Creek Health Center Pharmacy

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1851843965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ALEX LN",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042952",
            "telephone_number": "304-734-2040",
            "fax_number": "304-734-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 SISSONVILLE DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253129444",
            "telephone_number": "304-343-8030",
            "fax_number": "304-343-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISSONVILLE HEALTH CENTER PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CABIN CREEK HEALTH CENTER INC",
        "enumeration_date": "2016-10-25",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "LEAD PHARMACIST",
        "authorized_official_telephone_number": "681-205-8730",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851843965",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2170333",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sissonville Health Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sissonville Health Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.