Organization
MIKES BEST PRACTICES PHARMACY LLC
Active
Other names
Mike's Best Practices Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CRADDOCK (OWNER/PIC)
(276) 335-2153
Entity
Organization
Contact information
Practice address
710 W RIDGE RD, SUITE A, WYTHEVILLE, VA 24382-1095
(276) 335-2127
(276) 335-2102
Mailing address
PO BOX 1318, WYTHEVILLE, VA 24382-8318
(276) 335-2127
(276) 335-2102
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004698
VA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159688
PK
—
Enumeration date
04/25/2016
Last updated
08/12/2016
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