Organization
ULTRAPHARM,INC T/A WONDER DRUG SOUTHEAST PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA A CHOPSKI (OWNER/PRES)
(540) 343-9306
Entity
Organization
Contact information
Practice address
1224A JAMISON AVE, ROANOKE, VA 24013-1909
(540) 393-9306
(540) 393-9307
Mailing address
1224A JAMISON AVE SE, ROANOKE, VA 24013-1909
(540) 393-9306
(540) 393-9307
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0201002967
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8545057
—
VA
Enumeration date
03/15/2006
Last updated
08/22/2020
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