Individual
GREGORY BRIAN MULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
11231 INDIAN CREEK RD, POUND, VA 24279
(276) 796-2200
(276) 796-2202
Mailing address
PO BOX 1480, POUND, VA 24279-1480
(276) 870-4759
(276) 796-2202
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202011428
VA
3336C0003X
Community/Retail Pharmacy
0202011428
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010266238
—
VA
05
—
7100266980
—
KY
Enumeration date
12/17/2020
Last updated
12/17/2020
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