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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