Organization
TOM LAMARTINA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN PAYNE PHARMD (PIC/OWNER)
(434) 376-2220
Entity
Organization
Contact information
Practice address
120 RUSH ST W, BROOKNEAL, VA 24528-3026
(434) 376-2220
(434) 376-2220
Mailing address
PO BOX 66, BROOKNEAL, VA 24528-0066
(434) 376-2220
(434) 376-2220
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0201000073
VA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4805151
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8502803
—
VA
Enumeration date
10/10/2006
Last updated
01/21/2021
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