Provider Demographics
NPI:1851503601
Name:CARDINAL INC
Entity type:Organization
Organization Name:CARDINAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:304-232-6527
Mailing Address - Street 1:PO DRAWER 6771
Mailing Address - Street 2:2129 MARKET ST
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003
Mailing Address - Country:US
Mailing Address - Phone:304-232-6527
Mailing Address - Fax:304-232-8730
Practice Address - Street 1:2129 MARKET ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-232-6527
Practice Address - Fax:304-232-8730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810007940Medicaid