Organization
MOUNTAIN RX LLC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DAVID FLEMING RPH (OWNER PHARMACIST)
(540) 777-7500
Entity
Organization
Contact information
Practice address
3324 WILLIAMSON RD NW, ROANOKE, VA 24012-4058
(540) 777-7500
(540) 777-7504
Mailing address
3324 WILLIAMSON RD NW, ROANOKE, VA 24012-4058
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0201003650
VA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4834431
NCPDP #
VA
01
—
4834431
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8519111
—
VA
Enumeration date
08/31/2006
Last updated
03/07/2023
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