| NPI | 1861490344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLYN W GRISWOLD Pharmacy Director / Manager 757-253-5327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: VA 0201001059) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2020-08-22 |