Organization
COMMUNITY RESOURCE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN E. WALL R.PH. (PHARMACIST-IN-CHARGE)
(804) 524-7657
Entity
Organization
Contact information
Practice address
26317 WEST WASHINGTON STREET,, EXTENDED BUILDING #110, PETERSBURG, VA 23803
(804) 524-7657
(804) 524-7079
Mailing address
PO BOX 4030, PETERSBURG, VA 23803-0030
(804) 524-7657
(804) 524-7079
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
0201004069
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4813297
NABP NUMBER
VA
Enumeration date
03/14/2006
Last updated
08/22/2020
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