| NPI | 1750671368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL T LEDERHOUSE Pharmacist/Owner 540-723-6883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: VA 0201003469) |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2011-04-15 |