| NPI | 1174680128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBIE JEAN THOMPSOM Owner 434-971-3560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: VA 10-f-001) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2022-07-21 |