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Organization

BROADWAY DRUG CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NELSON L SHOWALTER RPH (OWNER)
(540) 896-3251
Entity
Organization

Contact information

Practice address
169 E SPRINGBROOK RD, BROADWAY, VA 22815-0245
(540) 896-3251
Mailing address
PO BOX 245, BROADWAY, VA 22815-0245
(540) 896-3251
(540) 896-5411

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201002376
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010366232
VA
05
0139073000
WV
Enumeration date
11/13/2006
Last updated
01/08/2009
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