| NPI | 1790148617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNY EDWARD STEVENS Pharmacy Manager 434-799-0162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: VA 0202010116) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |