| NPI | 1659821361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WING PLATT Owner 540-723-6883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: VA 0202006257) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy (Licence: VA 0202006257) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |