| NPI | 1679595516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS GOODE PIC 757-247-9554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: VA 0201001300) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |