# MARTINSVILLE PHARMACY INC

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

## Provider details

- **NPI number:** 1992231401
- **Authorized official:** JAMES DENNIS GLASS R.PH (PHARMACY MANAGER)
- **Authorized official phone:** (276) 632-0816

## Contact information

- **Practice address:** 1049 BROOKDALE ST, STE A, MARTINSVILLE, VA 24112-3971
- **Practice address phone:** (276) 632-0816
- **Practice address fax:** (276) 632-0871
- **Mailing address:** 1049 BROOKDALE ST, STE A, MARTINSVILLE, VA 24112-3971
- **Mailing address phone:** (276) 632-0816
- **Mailing address fax:** (276) 632-0871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 0201004762 | VA | Yes |

## Other

- **Enumeration date:** 05/03/2017
- **Last updated:** 05/03/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1841738895 | — | VA |