Community Phcy Of South Boston Inc
LBN: Community Phcy Of South Boston,Inc
Community Phcy Of South Boston Inc is an health care organization with primary practice located at 2202 Beechmont Rd , South Boston VA 24592-1614. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Community Phcy Of South Boston,Inc can be contacted via phone (434) 575-7988, or through Fisher, Samuel via phone (434) 575-7988.
Contact Information
Primary practice address
2202 Beechmont Rd
South Boston VA 24592-1614
Phone: (434) 575-7988
Fax: (434) 575-1358
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 0201001935 | Virginia |
Profile Details
| NPI number | 1700891306 |
|---|---|
| LBN Legal business name | Community Phcy Of South Boston,Inc |
| DBA Doing business as | Community Phcy Of South Boston Inc |
| Authorized official | Fisher, Samuel |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 30th, 2006 |
| Last updated | Nov 7th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700891306 | NPPES |
| Other | 4809628 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 8508259 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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