Organization
SERVANT PHARMACY OF VIRGINIA INC
Active
Other names
Servant Pharmacy of Virginia
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY ANGEL (OWNER/COO)
(919) 760-5483
Entity
Organization
Contact information
Practice address
10370 BATTLEVIEW PKWY, MANASSAS, VA 20109-2338
(678) 303-1680
(678) 303-1686
Mailing address
2451 CUMBERLAND PKWY SE, SUITE 3694, ATLANTA, GA 30339-6136
(678) 303-1680
(678) 303-1686
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
0201004415
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131606
PK
—
Enumeration date
08/29/2011
Last updated
03/12/2014
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