Organization
FORK UNION PHARMACY INC
Active
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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