Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mountain Lake Pharmacy Inc

Organization Pharmacy · NPI 1336228006

Mountain Lake Pharmacy Inc is a Pharmacy in Summersville, West Virginia. Licensed in West Virginia. Registered with an NPI since 2006.

Licensed in
WV
In the registry since
2006
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1129 Broad St Ste 100
Summersville, WV 26651-1838
Phone: (304) 872-9000
Fax: (304) 872-4419
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence SP0552314 (WV)
Pharmacy Taxonomy 333600000X

Record details

NPI number1336228006
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Howard Boone — President Pic · (304) 872-9000
Other names Mountain Lake Pharmacy
NPI enumeratedNovember 3, 2006
Last updated in NPPESSeptember 10, 2010
Mailing address1129 Broad St, Ste 100, Summersville, WV 26651-1838

Other providers in Summersville