Provider Demographics
NPI:1386361541
Name:THREE SPRINGS VILLAGE PHARMACY LLC
Entity type:Organization
Organization Name:THREE SPRINGS VILLAGE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:V
Authorized Official - Last Name:LONGHI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-723-2528
Mailing Address - Street 1:204 THREE SPRINGS DR STE A
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3815
Mailing Address - Country:US
Mailing Address - Phone:304-723-2528
Mailing Address - Fax:304-723-2540
Practice Address - Street 1:204 THREE SPRINGS DR STE A
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3815
Practice Address - Country:US
Practice Address - Phone:304-723-2528
Practice Address - Fax:304-723-2540
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THREE SPRINGS VILLAGE PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy