Organization
OLD DOMINION PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MICHAEL RAKOWSKI (MANAGING MEMEBR)
(800) 718-6003
Entity
Organization
Contact information
Practice address
8792 SACRAMENTO DR, SUITE I, ALEXANDRIA, VA 22309-1676
(800) 718-6003
Mailing address
8792 SACRAMENTO DR, SUITE I, ALEXANDRIA, VA 22309-1676
(800) 718-6003
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201004590
VA
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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