Whitehall Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

MP0552374 Issued in WV

Legal business name

WHITEHALL PHARMACY LLC

Doing business as

White Hall Pharmacy LLC

Practice address

177 Middletown Rd
Suite 2
Fairmont, WV 26554-8254

Phone

(304) 368-9355

Fax

(304) 368-5422

NPI assigned

Dec 9, 2008

Organization subpart

No

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

Authorized official

Name

Terri Vilain

Title

RPH/Owner

Phone

(304) 368-9355

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• White Hall Pharmacy LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in WV2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Adam H Hartman, PHARMD

  • Pharmacist
  • Fairmont, WV
  • NPI 1801183017
  NPD (past)

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1962647719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 MIDDLETOWN RD",
            "address_2": "SUITE 2",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265548254",
            "telephone_number": "304-368-9355",
            "fax_number": "304-368-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 MIDDLETOWN RD",
            "address_2": "SUITE 2",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265548254",
            "telephone_number": "304-368-9355",
            "fax_number": "304-368-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITEHALL PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-09",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "VILAIN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "RPH/OWNER",
        "authorized_official_telephone_number": "304-368-9355"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "MP0552374",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810013966",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2118003",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Hall Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Ann White
• Tina Elisa White
• Sherie Yvonne Whitecotton
• Anita Whitehair
• Whitehall Medical PLLC
• Elizabeth Jane Whitelock
• Katherine Anne Wickerd
• Trisha Nicole Wickline
• Frank Wiechers, FNP-BC
• Julie A Wiggs

• Community/Retail Pharmacy in Fairmont, WV
• Providers in Fairmont, 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 Jul 8, 2024; 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.