OrganizationActive
Mountaineer Medical Pharmacy LLC
NPI 1134569668 · Community/Retail Pharmacy · Bridgeport, WV
Mountaineer Medical Pharmacy LLC is a Community/Retail Pharmacy organization in Bridgeport, WV (NPI 1134569668).
Provider details
- NPI number
- 1134569668
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Michael Kovack, Pharm Mgr(304) 423-5000
- License
- SP0552456 (WV)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
120 Medical Park Dr Ste 102
Bridgeport, WV 26330-9013
Phone: (304) 423-5200
Fax: (304) 848-6050
Street-level locationGet directions
Mailing address
120 Medical Park Dr Ste 102
Bridgeport, WV 26330-9013
Other names (DBA / former)
- Doing business as
- Mountaineer Medical Pharmacy LLC
Registry dates
- Enumerated
- 2013-06-28
- Last updated
- 2013-10-26
Frequently asked questions
- What is Mountaineer Medical Pharmacy LLC's NPI number?
- Mountaineer Medical Pharmacy LLC's National Provider Identifier (NPI) is 1134569668, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mountaineer Medical Pharmacy LLC?
- Mountaineer Medical Pharmacy LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Mountaineer Medical Pharmacy LLC located?
- Mountaineer Medical Pharmacy LLC's practice location on file with NPPES is 120 Medical Park Dr Ste 102, Bridgeport, WV 26330-9013.
- What is Mountaineer Medical Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Mountaineer Medical Pharmacy LLC is (304) 423-5200.
- Who is the authorized official for Mountaineer Medical Pharmacy LLC?
- The authorized official listed on Mountaineer Medical Pharmacy LLC's NPPES record is Michael Kovack, Pharm Mgr. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mountaineer Medical Pharmacy LLC's NPI active?
- Yes — Mountaineer Medical Pharmacy LLC's NPI (1134569668) is active in the NPPES registry as of the last update on 2013-10-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.