| NPI | 1992231401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DENNIS GLASS Pharmacy Manager 276-632-0816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: VA 0201004762) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |