Organization
CAVALIER PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK L MULLINS PHARMD (PHARMACIST OWNER)
(276) 328-9141
Entity
Organization
Contact information
Practice address
301 CHURCH ST, WISE, VA 24293
(276) 328-9141
(276) 328-9130
Mailing address
PO BOX 1406, 301 CHURCH STREET, WISE, VA 24293-1406
(276) 328-9141
(276) 328-9141
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202012914
VA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201003976
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010076366
—
VA
Enumeration date
07/13/2006
Last updated
06/10/2014
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