Organization
STREET DRUG CORPORATION
Active
Other names
FAMILY DRUG CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH STREET RPH (VP PHARMACY)
(276) 889-1919
Entity
Organization
Contact information
Practice address
110 W MAIN ST, LEBANON, VA 24266-4214
(276) 889-1919
(276) 889-4635
Mailing address
110 W MAIN ST, LEBANON, VA 24266-4214
(276) 889-1919
(276) 889-4635
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201002833
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008531315
—
VA
01
—
2104077
PK
—
Enumeration date
11/14/2005
Last updated
08/26/2014
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