Organization
HDMC PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARVIS T GRIFFIN DHA, LNHA, CPHQ (FACILITY DIRECTOR/CEO)
(804) 524-7112
Entity
Organization
Contact information
Practice address
26317 W WASHINGTON STREET EXTENDED, PETERSBURG, VA 23803
(804) 524-7744
(804) 524-4718
Mailing address
26317 W WASHINGTON STREET EXTENDED, PETERSBURG, VA 23803
(804) 524-7744
(804) 524-4718
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0201001240
VA
3336L0003X
Long Term Care Pharmacy
0201001240
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49-0104/495113
—
VA
Enumeration date
01/04/2006
Last updated
06/16/2023
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