Organization
MEDICAL PARK PHARMACY INC
Active
Other names
MEDICAL PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LEANNE VANMETER RPH (PRESIDENT)
(276) 935-6455
Entity
Organization
Contact information
Practice address
1503 SLATE CREEK RD, GRUNDY, VA 24614-6974
(276) 935-6455
(276) 935-2981
Mailing address
1503 SLATE CREEK RD, GRUNDY, VA 24614-6974
(276) 935-6455
(276) 935-2981
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201002298
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0144027000
—
WV
01
—
2104298
PK
—
05
—
54019989
—
KY
05
—
8515476
—
VA
Enumeration date
09/21/2006
Last updated
05/05/2016
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