# EASTERN STATE HOSPITAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** ESH Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588764997
- **Authorized official:** MR. JACK L. WOOD NHA (HOSPITAL DIRECTOR)
- **Authorized official phone:** (757) 253-5241

## Contact information

- **Practice address:** 4601 IRONBOUND RD, WILLIAMSBURG, VA 23188-2652
- **Practice address phone:** (757) 253-5241
- **Practice address fax:** (757) 253-5065
- **Mailing address:** 4601 IRONBOUND RD, WILLIAMSBURG, VA 23188-2652
- **Mailing address phone:** (757) 253-5241
- **Mailing address fax:** (757) 253-5065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 11/23/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0010230314 | — | VA |
| 01 | — | 004811659 | MEDICARE PART D | VA |