Organization
NELSON L SHOWALTER TA BROADWAY DRUG CENTER
Active
Other names
Broadway Drug Center, LLC
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 22815-9526
(540) 896-3251
(540) 896-5411
Mailing address
169 E SPRINGBROOK RD, PO BOX 245, BROADWAY, VA 22815-9526
(540) 896-3251
(540) 896-5411
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0139073000
—
WV
Enumeration date
11/04/2005
Last updated
08/22/2020
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