Provider Demographics
NPI:1588718878
Name:NEWPAGE PHARMACY
Entity type:Organization
Organization Name:NEWPAGE PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-355-2700
Mailing Address - Street 1:22 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26750-1036
Mailing Address - Country:US
Mailing Address - Phone:304-355-2700
Mailing Address - Fax:304-355-8800
Practice Address - Street 1:22 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:WV
Practice Address - Zip Code:26750-1036
Practice Address - Country:US
Practice Address - Phone:304-355-2700
Practice Address - Fax:304-355-8800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSP0552261305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5010272OtherNCPDP