| NPI | 1265843833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LOGUE Pharmacist 757-876-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: VA 0201004399) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2014-05-16 |