Organization
JEFF DALTON INC MEDICINE SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF DALTON R.P.H (PRESIDENT)
(434) 369-5257
Entity
Organization
Contact information
Practice address
1230 MAIN ST, ALTAVISTA, VA 24517-1466
(434) 369-5257
(434) 369-1061
Mailing address
1230 MAIN ST, ALTAVISTA, VA 24517-1466
(434) 369-5257
(434) 369-1061
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0201003405
VA
3336C0003X
Community/Retail Pharmacy
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008517371
—
VA
05
—
010332591
—
VA
Enumeration date
10/04/2006
Last updated
03/07/2023
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