Organization
LIVELY DRUG COMPANY INC
Active
Organization
LIVELY DRUG COMPANY INC
Active
Other names
LIVELY DRUG CO INC
Organization subpart
No
Provider details
NPI number
Authorized official
THOAMS BEANE RPH (OWNER PHARMACIST)
(804) 462-5644
Entity
Organization
Contact information
Practice address
36 LIVELY OAKS RD, STATE RT 3, LIVELY, VA 22507
(804) 462-5644
(804) 462-5667
Mailing address
PO BOX 399, LIVELY, VA 22507-0399
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201000427
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4806824
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
8503516
—
VA
Enumeration date
09/21/2006
Last updated
11/05/2010
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