CMC PHARMACY, LLC (NPI# 1124575907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124575907 |
| Entity Type | Organization |
| Organization Name | CMC PHARMACY, LLC |
| Other Organization Name | MED CENTER SPECIALTY PHARMACY |
| Practice Address |
3100 Maccorkle Ave Se Suite 100 Charleston WV 25304-1223 |
| Practice Telephone | 3043448021 |
| Practice Fax Number | 3043440655 |
| Mailing Telephone | 3043448021 |
| Mailing Fax Number | 3043440655 |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2020-02-18 |
| Authorized Official Name | NICHOLAS KARALIS (CEO) |
| Authorized Official Telephone | 6105456040 |
| Is Organization Subpart | Y |
| Parent Organization Name | ELWYN PHARMACY GROUP, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
SP0552442 | WV | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
SP0552442 | WV | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | BOARD OF PHARMACY | SP055242 | 01 |
| WV | 3810025009 | 05 |
| Other Name | Type Code |
|---|---|
| Med Center Specialty Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336485663 | Cmc Pharmacy, LLC | Pharmacy | 3100 Maccorkle Ave Se Ste 100, Charleston, WV 25304-1215 | 2012-12-13 |
| Street Address |
3100 MACCORKLE AVE SE SUITE 100 |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25304-1223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053312314 | Kurt M. Nellhaus, M.d. | Internal Medicine | 3100 Maccorkle Ave Se, Suite 806, Charleston, WV 25304-1223 | 2005-08-09 |
| 1386191575 | William F. Brogan | Nurse Practitioner | 3100 Maccorkle Ave Se, Suite 301, Charleston, WV 25304-1223 | 2016-09-06 |
| 1083161475 | Amanda L. Newcomer | Nurse Practitioner | 3100 Maccorkle Ave Se, Suite 301, Charleston, WV 25304-1223 | 2016-09-02 |
| 1437508868 | Brandon Waskey | Nurse Practitioner | 3100 Maccorkle Ave Se, Suite 700, Charleston, WV 25304-1223 | 2016-06-07 |
| 1992177984 | Sandra Henline | Physician Assistant | 3100 Maccorkle Ave Se, Suite 411, Charleston, WV 25304-1223 | 2015-10-29 |
| 1598157430 | Wv Heart and Vascular Institute Charleston | Internal Medicine | 3100 Maccorkle Ave Se, Suite 610, Charleston, WV 25304-1223 | 2015-03-02 |
| 1922403435 | Chad L. Miller | Physician Assistant | 3100 Maccorkle Ave Se, Suite 101, Charleston, WV 25304-1223 | 2014-10-27 |
| 1114321809 | Jennifer J. Hancock | Psychologist | 3100 Maccorkle Ave Se, Suite 101, Charleston, WV 25304-1223 | 2014-10-09 |
| 1720487267 | Deborah Rectenwald | Nurse Practitioner | 3100 Maccorkle Ave Se, Suite 406, Charleston, WV 25304-1223 | 2014-08-21 |
| 1184057614 | Carla Ann Hively | Pharmacist | 3100 Maccorkle Ave Se, Suite 101, Charleston, WV 25304-1223 | 2013-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893908 | Sade Yvonne Rice | Technician | 392 B South Parkd Rd, Charleston, WV 25304 | 2020-08-27 |
| 1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
| 1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
| 1447811872 | Kwasi Amponsah Gambrah | Student in an Organized Health Care Education/Training Program | 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 | 2019-06-26 |
| 1457916751 | Divya Kalluru | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 | 2019-05-02 |
| 1841854965 | Sean Michael Percy Losier | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 | 2019-04-24 |
| 1700440047 | Priyanka Chowdhry | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 | 2019-04-23 |
| 1568925469 | Saranya Dinesan | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 | 2019-04-09 |
| 1043771694 | Mary Elizabeth Novak | Student in an Organized Health Care Education/Training Program | Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 | 2019-03-27 |
| 1124518600 | Abdullah Sohail | Student in an Organized Health Care Education/Training Program | 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 | 2018-05-10 |
| Find all providers in zip 25304 | ||||
| Taxonomy Code | 3336H0001X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Home Infusion Therapy Pharmacy |
| Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. |
| Notes: Source: National Home Infusion Association [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659712958 | Claire-frances Health Services | Pharmacy | 2568 Pennsylvania Ave, Charleston, WV 25302 | 2013-07-15 |
| 1285793281 | Loop Plaza Pharmacy Co Inc | Pharmacy | 4918 Maccorkle Ave Se, Charleston, WV 25304-2052 | 2006-12-06 |
| 1336485663 | Cmc Pharmacy, LLC | Pharmacy | 3100 Maccorkle Ave Se Ste 100, Charleston, WV 25304-1215 | 2012-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063879096 | Hpc Specialty Rx West Virginia Inc | Pharmacy | 118 Lafayette Ave Ste 200, Moundsville, WV 26041-1029 | 2016-01-21 |
| 1245421312 | Grant Memorial Hospital Home Infusion Therapy Services | Pharmacy | Rt 4 and 28, Petersburg, WV 26847 | 2007-08-05 |
| 1457343451 | Home Care Plus, Inc. | Pharmacy | Rr 2 Box 169g, Greyrock Professional Bldg., Lewisburg, WV 24901-9316 | 2005-08-17 |
| 1750441960 | Hurley Drug Co Inc | Pharmacy | 210 Logan St, Williamson, WV 25661 | 2006-12-11 |
| City | CHARLESTON |
| Zip Code | 25304 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.