Organization
MEDICAL VILLAGE PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD JAMES SHOKES RPH (PRESIDENT)
(828) 322-4505
Entity
Organization
Contact information
Practice address
815 FAIRGROVE CHURCH RD, CONOVER, NC 28613-8609
(828) 322-4505
(828) 322-2669
Mailing address
815 FAIRGROVE CHURCH RD, CONOVER, NC 28613-8609
(828) 322-4505
(828) 322-2669
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
3132
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0185355
—
NC
Enumeration date
05/01/2006
Last updated
05/24/2011
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