Organization
MARTINSVILLE FAMILY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PRATT (PRESIDENT)
(276) 634-0922
Entity
Organization
Contact information
Practice address
1049A BROOKDALE ST, MARTINSVILLE, VA 24112-3950
(276) 634-0922
(276) 634-5048
Mailing address
PO BOX 4589, MARTINSVILLE, VA 24115-4589
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201003742
VA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4836144
OTHER ID NUMBER
—
Enumeration date
07/07/2006
Last updated
09/13/2007
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