Organization
GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC
Active
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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