| NPI | 1235510314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BOYETTE CRAVEN Pharmacist In Charge 757-567-0798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: VA 0201004651) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2016-05-31 |