Organization
DINWIDDIE DRUG STORE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES A. RAINEY JR. (OWNER)
(804) 469-3261
Entity
Organization
Contact information
Practice address
13723 BOYDTON PLANK RD, DINWIDDIE, VA 23841-0215
(804) 469-3261
(804) 469-4623
Mailing address
PO BOX 215, DINWIDDIE, VA 23841-0215
(804) 469-3261
(804) 469-4623
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201003019
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008500908
—
VA
Enumeration date
06/07/2006
Last updated
07/24/2012
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