Provider Demographics
NPI:1407642598
Name:MANNINGTON PHARMACY
Entity type:Organization
Organization Name:MANNINGTON PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNA
Authorized Official - Middle Name:SHAY
Authorized Official - Last Name:HARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-815-2165
Mailing Address - Street 1:720 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANNINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26582-1259
Mailing Address - Country:US
Mailing Address - Phone:304-986-3811
Mailing Address - Fax:304-986-3813
Practice Address - Street 1:720 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MANNINGTON
Practice Address - State:WV
Practice Address - Zip Code:26582-1259
Practice Address - Country:US
Practice Address - Phone:304-986-3811
Practice Address - Fax:304-986-3813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy