Organization
FAMILY DRUG CENTER
Active
Organization
FAMILY DRUG CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLDEEN BAGWELL (OWNER)
(276) 935-8797
Entity
Organization
Contact information
Practice address
STATE ROUTE 80, DAVENPORT, VA 24239-0129
(276) 859-0409
(276) 859-0329
Mailing address
PO BOX 129, DAVENPORT, VA 24239-0129
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201002977
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010187303
—
VA
01
—
4826662
OTHER ID NUMBER
—
Enumeration date
10/11/2006
Last updated
06/26/2008
Update your record
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