Organization
SUBURBAN PHARMACY INC
Active
Other names
suburban pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SUNIL KANDREGULA (MANAGER)
(757) 397-2377
Entity
Organization
Contact information
Practice address
3701 KING ST, PORTSMOUTH, VA 23707-3115
(757) 397-2377
(757) 399-2013
Mailing address
3701 KING ST, PORTSMOUTH, VA 23707-3115
(757) 397-2377
(757) 399-2013
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201002490
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149751
PK
—
Enumeration date
12/18/2006
Last updated
01/27/2015
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