1. Home
  2. Directory
  3. West Virginia
  4. Montgomery
  5. Pharmacy
  6. NPI Profile

MGH OUTPATIENT PHARMACY
NPI 1164104592
Pharmacy - Community/Retail Pharmacy in Montgomery, WV

Active since August 04, 2023CLIA 51D2291872 · Waiver
401 6TH AVE, MONTGOMERY, WV 25136(304) 442-5151(304) 442-7494 Get Directions Write a Review

NPPES record last updated: August 25, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mgh Outpatient Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MGH OUTPATIENT PHARMACY (NPI 1164104592) is a healthcare organization registered as a community/retail pharmacy in Montgomery, West Virginia and active in the NPI registry since August 2023. The organization holds a CLIA Waiver certificate valid through October 16, 2027 and lists Donna Raynes, Administration, as its authorized official.

NPPES Registry Identity

NPI1164104592
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameMONTGOMERY GENERAL HOSPITAL, INC
Location Address401 6TH AVEMontgomery, WV 25136-2116
Mailing AddressPo Box 270Montgomery, WV 25136-0270 · (304) 442-5151 · Fax (304) 442-7494
Phone(304) 442-5151
Fax(304) 442-7494
Organization SubpartYes
Authorized OfficialDonna RaynesAdministration · (304) 442-5151
Enumeration DateAugust 4, 2023
Last NPPES UpdateAugust 25, 2023
NPPES CertifiedAugust 25, 2023
✔ NPI 1164104592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
401 6TH AVE, Montgomery, WV 25136
Open in Google Maps ↗

Other Names 1

Doing Business AsMgh Outpatient Pharmacy

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc. and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 51D2291872

Montgomery General Hospital/Urology Clinic · Montgomery, WV
Active · expires Oct 16, 2027
CLIA Number51D2291872
Laboratory TypePhysician Office
Certificate Effective DateOctober 17, 2025
Certificate Expiration DateOctober 16, 2027
Laboratory DirectorDr. Sammar Atassi
Laboratory Phone(304) 442-2521
Laboratory LocationMontgomery General Hospital/Urology Clinic401 Sixth Avenue Suite 202, Montgomery, WV 25136
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MONTGOMERY GEN CAHGRP
Family Medicine
401 6TH AVE
MONTGOMERY, WV 25136
Fayette County (304) 442-5151
COAL VALLEY PHYSICIANS INC
Family Medicine
401 6TH AVE, D303
MONTGOMERY, WV 25136
Fayette County (304) 442-9582
AARON BAILEY
Physician Assistant
401 6TH AVE
MONTGOMERY, WV 25136
Fayette County (304) 442-7477
LAURA SHEETS COTA/L
Occupational Therapy Assistant
401 6TH AVE
MONTGOMERY, WV 25136
Fayette County (304) 442-7416
REAGAN JOHNSON
Physician Assistant
401 6TH AVE
MONTGOMERY, WV 25136
Fayette County (304) 442-5151
ROBERT MICHAEL EGGLESTON MD
Internal Medicine
401 6TH AVE, SUITE 301
MONTGOMERY, WV 25136
Fayette County (304) 442-2521
MONTGOMERY GENERAL HOSPITAL, INC
Clinic/Center (Rural Health)
401 6TH AVE
MONTGOMERY, WV 25136
Fayette County (304) 442-5151
DR. GHASSAN Y DAGHER MD
Ophthalmology
401 6TH AVE, SUITE 110
MONTGOMERY, WV 25136
Fayette County (304) 442-8076

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Montgomery General Hospital, Inc's NPI number?

The NPI number for Montgomery General Hospital, Inc is 1164104592. It was assigned to this organization in the NPPES registry on August 4, 2023. The provider is doing business as Mgh Outpatient Pharmacy.

Where is Montgomery General Hospital, Inc located?

Montgomery General Hospital, Inc is located at 401 6th Ave, Montgomery, WV 25136. The listed phone number is (304) 442-5151.

What is Montgomery General Hospital, Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Montgomery General Hospital, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 51D2291872) is associated with this NPI, valid through October 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Montgomery General Hospital, Inc accept?

Health plans from Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., AvMed and Avera Health Plans and 19 other insurers list Montgomery General Hospital, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Montgomery General Hospital, Inc was last updated on August 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.