Organization
APPOMATTOX DRUG STORE INC
Active
Other names
APPOMATTOX DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE MITCHELL (GENERAL MANAGER)
(434) 352-7161
Entity
Organization
Contact information
Practice address
2046 CONFEDERATE BLVD, APPOMATTOX, VA 24522-4097
(434) 352-7161
(434) 352-2180
Mailing address
PO BOX 489, APPOMATTOX, VA 24522-0489
(434) 352-7161
(434) 352-2180
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201001785
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008511268
—
VA
01
—
2102351
PK
—
05
—
8511268
—
VA
Enumeration date
07/04/2006
Last updated
12/11/2023
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