| NPI | 1861565731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ELLIOTT Coordinator Third Party Payors 434-517-3156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: VA H1853) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-08-22 |