Organization
GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC
Active
Other names
Lunera Pharmacy Manassas
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN OTIS HARRIS (CEO)
(661) 381-0458
Entity
Organization
Contact information
Practice address
9705 LIBERIA AVE STE 201, MANASSAS, VA 20110-1744
(571) 402-7024
Mailing address
9705 LIBERIA AVE STE 201, MANASSAS, VA 20110-1744
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201005173
LICENSE
VA
Enumeration date
10/21/2025
Last updated
11/19/2025
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