Organization
KING WILLIAM PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA SCHOONOVER (PIC)
(804) 769-3885
Entity
Organization
Contact information
Practice address
7890 B RICHMOND TAPPAHANOCK HWY, AYLETT, VA 23009
(804) 769-3885
(804) 769-4413
Mailing address
PO BOX 29, AYLETT, VA 23009-0029
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201001236
VA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2102229
PK
—
05
—
8509638
—
VA
Enumeration date
09/21/2006
Last updated
12/14/2017
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