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MAIN STREET PHARMACY INC
NPI 1306505763
Pharmacy - Community/Retail Pharmacy in South Charleston, WV

Active since December 14, 2021
4501 MACCORKLE AVE SW STE 101, SOUTH CHARLESTON, WV 25309(304) 766-8484(304) 766-8344 Get Directions Write a Review

NPPES record last updated: December 14, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Main Street Pharmacy Inc NPPES

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

MAIN STREET PHARMACY INC (NPI 1306505763), doing business as Clark's Family Pharmacy Inc., is a healthcare organization registered as a community/retail pharmacy in South Charleston, West Virginia and active in the NPI registry since December 2021. The organization lists Carol A Jones, Manager, as its authorized official.

NPPES Registry Identity

NPI1306505763
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameMAIN STREET PHARMACY INC
Location Address4501 MACCORKLE AVE SW STE 101South Charleston, WV 25309-1444
Mailing Address4501 Maccorkle Ave Sw Ste 101South Charleston, WV 25309-1444 · (304) 766-8484 · Fax (304) 766-8344
Phone(304) 766-8484
Fax(304) 766-8344
Organization SubpartYesParent: Main Street Pharmacy, Inc.
Authorized OfficialCarol A JonesManager · (304) 465-7200
Enumeration DateDecember 14, 2021
NPPES CertifiedDecember 10, 2021
✔ NPI 1306505763 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.
4501 MACCORKLE AVE SW STE 101, South Charleston, WV 25309
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Other Names 1

Doing Business AsClark's Family Pharmacy Inc.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness, Ambetter from Buckeye Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Main Street Pharmacy Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateWest VirginiaEnrollment IDO20220128000680Non-DME Part B · Mass Immunization (Roster Biller Only)Due dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 3

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

PHARMACY ASSOCIATES, INC
Durable Medical Equipment & Medical Supplies
4501 MACCORKLE AVE SW STE 101
SOUTH CHARLESTON, WV 25309
Kanawha County (800) 815-7540
MR. JORDAN HAYNES RPH
Pharmacist
4501 MACCORKLE AVE SW STE 101
SOUTH CHARLESTON, WV 25309
Kanawha County (304) 766-8484
BUY-FAST PHARMACY
Pharmacy (Community/Retail Pharmacy)
4501 MACCORKLE AVE SW STE 101
SOUTH CHARLESTON, WV 25309
Kanawha County (304) 766-8484

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 Main Street Pharmacy Inc's NPI number?

The NPI number for Main Street Pharmacy Inc is 1306505763. It was assigned to this organization in the NPPES registry on December 14, 2021. The provider is doing business as Clark's Family Pharmacy Inc..

Where is Main Street Pharmacy Inc located?

Main Street Pharmacy Inc is located at 4501 Maccorkle Ave SW Ste 101, South Charleston, WV 25309. The listed phone number is (304) 766-8484.

What is Main Street Pharmacy Inc's specialty?

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

Is Main Street Pharmacy Inc enrolled in Medicare?

Yes. Main Street Pharmacy Inc is registered in the Medicare PECOS enrollment system.

When is Main Street Pharmacy Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (West Virginia, Mass Immunization (Roster Biller Only)) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does Main Street Pharmacy Inc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and Ambetter from Buckeye Health Plan and 26 other insurers list Main Street Pharmacy 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 Main Street Pharmacy Inc was last updated on December 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.