Organization
KMART PHARMACY #4062
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE ADAMS-LOVELACE (PHARMACIST)
(434) 799-0162
Entity
Organization
Contact information
Practice address
3311 RIVERSIDE DR, DANVILLE, VA 24541-3430
(434) 799-0162
(847) 396-2798
Mailing address
455 SYCAMORE CIR, DANVILLE, VA 24540-5356
(434) 791-1733
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0202011002
VA
Other
Enumeration date
04/19/2016
Last updated
04/19/2016
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