| NPI | 1811460561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN PAYNE President/Pharmacy Manager 434-425-0701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-01-05 |
| Last Update Date | 2020-11-19 |