Organization
HAIRSTON & DIXON INC
Active
Other names
CENTREVILLE MEDICAL ARTS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERNEST DIXON RPH (OWNER)
(703) 266-3667
Entity
Organization
Contact information
Practice address
14260C CENTREVILLE SQ, CENTREVILLE, VA 20121-2364
(703) 266-3667
(703) 266-3361
Mailing address
14260C CENTREVILLE SQ, CENTREVILLE, VA 20121-2364
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201004231
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118486145
—
VA
01
—
4840941
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/30/2008
Last updated
11/11/2010
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