| NPI | 1841397684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL VINSON Owner 540-955-3095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: VA 0201001553) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2010-03-16 |