| NPI | 1659527075 |
|---|---|
| Doing Business As | BOONSBORO PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RAM R NERAVETLA President 804-329-0077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: VA 0201004238) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 0210004238) |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: VA 0201004238) | |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |