MANCHIN FAMILY PHARMACY
NPI 1689849804
Pharmacy - Clinic Pharmacy in Fairmont, WV
- Organization
- Pharmacy
- Clinic Pharmacy
- CLIA Number: 51D0687206
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 04-01-2027
About MANCHIN FAMILY PHARMACY
This page provides the complete NPI Profile along with additional information for Manchin Family Pharmacy, a provider established in Fairmont, West Virginia operating as a Pharmacy, focusing in clinic pharmacy . The healthcare provider is registered in the NPI registry with number 1689849804 assigned on April 2008. The practitioner's primary taxonomy code is 3336C0002X with license number SP0552377 (WV). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Manchin Family Pharmacy. The authorized official of this NPI record is John Manchin Iii B.s. (Owner)
- NPI
- 1689849804 Verify this NPI
- Provider Legal Name
- JOHN MANCHIN III
- Other Organization Name
- MANCHIN FAMILY PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 181 MIDDLETOWN CIR FAIRMONT, WV 26554
- Location Phone
- (304) 367-9122
- Location Fax
- (304) 367-9125
- Mailing Address
- 181 MIDDLETOWN CIR FAIRMONT, WV 26554
- Mailing Phone
- (304) 367-9122
- Mailing Fax
- (304) 367-9125
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-29-2008
- Last Update Date
- 04-25-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Clinic Pharmacy
- Taxonomy Code
- 3336C0002X
- Type
- Suppliers
- License No.
- SP0552377
- License State
- WV
- Taxonomy Description
- A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 3336C0003X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2111736 | OTHER (01) | PK | |
| 3810011348 | MEDICAID (05) | WV |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 51D0687206
- Facility Type
- Community Clinic
- Certificate Effective Date
- April 02, 2025
- Certificate Expiration Date
- April 01, 2027
- Laboratory Director
- JAMES S. NAMSUPAK MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Manchin Family Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1689849804, enumerated as an "organization" on April 29, 2008.
The provider is located at 181 MIDDLETOWN CIR FAIRMONT, WV 26554 and the phone number is (304) 367-9122.
Pharmacy with taxonomy code 3336C0002X and a focus in Clinic Pharmacy.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
