Madison Family Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

SP0552509 Issued in WV

Legal business name

MADISON FAMILY PHARMACY, LLC

Practice address

313 Madison Ave
Madison, WV 25130-1510

Phone

(304) 369-0209

Fax

(304) 369-1994

NPI assigned

Feb 9, 2017

Last updated

Feb 9, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles David Burdette

Title

President/Owner

Phone

(304) 369-0209

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1952849093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 MADISON AVE",
            "city": "MADISON",
            "state": "WV",
            "postal_code": "251301510",
            "telephone_number": "304-369-0209",
            "fax_number": "304-369-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 MADISON AVE",
            "city": "MADISON",
            "state": "WV",
            "postal_code": "251301510",
            "telephone_number": "304-369-0209",
            "fax_number": "304-369-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON FAMILY PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "BURDETTE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "304-369-0209"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0552509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Michelle Lindsay
• Lauren M Linville, FNP
• Rachel Loftus
• Amanda Dawn Lovejoy
• Elisabeth Ann Rika Lowe
• Madison Medical PLLC
• Madison Medical, PLLC
• Ethan Malcomb
• Paris Malcomb
• Brian Scott Mallory, D.C.

• Community/Retail Pharmacy in Madison, WV
• Providers in Madison, 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 9, 2017; 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.