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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