Organization
SPECIALTY CARE RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY V.A. WATERS III (MANAGER)
(406) 531-5888
Entity
Organization
Contact information
Practice address
111 FASHION RD STE ABC, POUNDING MILL, VA 24637-1200
(276) 345-0284
(276) 345-0284
Mailing address
111 FASHION RD STE ABC, POUNDING MILL, VA 24637-1200
(276) 345-0284
(276) 345-9356
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0201004783
VA
3336C0004X
Compounding Pharmacy
0201004783
VA
Other
Enumeration date
06/13/2017
Last updated
04/06/2023
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