Organization
KILMARNOCK PHARMACY INC
Active
Other names
MAIN STREET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLL THROCKMORTON RPH (OWNER)
(804) 435-8818
Entity
Organization
Contact information
Practice address
308 N MAIN ST, KILMARNOCK, VA 22482-3834
(804) 435-8818
(804) 435-8898
Mailing address
308 N MAIN ST, KILMARNOCK, VA 22482-3834
(804) 435-8818
(804) 435-8898
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201004077
VA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010265975
—
VA
01
—
4839227
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/04/2006
Last updated
10/10/2018
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