# CROWN RX INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184662082
- **Authorized official:** MRS. ADETOYOSI M AGANBI RPH, MSC HOSP. ADMIN (MANAGER)
- **Authorized official phone:** (804) 778-7288

## Contact information

- **Practice address:** 4936 LIPPINGHAM DR, CHESTER, VA 23831-6510
- **Practice address phone:** (804) 778-7288
- **Practice address fax:** (804) 777-9470
- **Mailing address:** 4936 LIPPINGHAM DR, CHESTER, VA 23831-6510
- **Mailing address phone:** (804) 778-7288
- **Mailing address fax:** (804) 777-9470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 0201004073 | VA | Yes |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4839188 | NCPDP | VA |