Organization
FORK UNION PHARMACY INC
Active
Other names
FORK UNION PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN YONCE (OWNER AND PHARMACIST)
(434) 842-3208
Entity
Organization
Contact information
Practice address
4316 B JAMES MADISON HWY, FORK UNION, VA 23055
(434) 842-3208
(434) 842-1447
Mailing address
PO BOX 187, FORK UNION, VA 23055-0187
(434) 842-3288
(434) 842-1447
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201000280
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417970880
—
VA
01
—
2102630
PK
—
05
—
8505357
—
VA
Enumeration date
07/25/2006
Last updated
10/04/2016
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