Provider Demographics
NPI:1912977588
Name:MEDI-SAVE PHARMACY INC
Entity type:Organization
Organization Name:MEDI-SAVE PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:IAMES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-788-6010
Mailing Address - Street 1:1405 BONNIE VIEW TER
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-2801
Mailing Address - Country:US
Mailing Address - Phone:304-788-6010
Mailing Address - Fax:304-788-5989
Practice Address - Street 1:1405 BONNIE VIEW TER
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-2801
Practice Address - Country:US
Practice Address - Phone:304-788-6010
Practice Address - Fax:304-788-5989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X, 332B00000X, 333600000X
WVSP05503703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2444411Medicaid
WV5009091Medicaid
MD404553000Medicaid
2110646OtherPK
VA010028881Medicaid
WV0140132000Medicaid
MD404553000Medicaid