Organization
HARNESS HEALTH PHARMACY - VIRGINIA LLC
Active
Other names
HARNESS HEALTH PHARMACY #512, Good Health Pharmacy At Mary Immaculate Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY M RALSTON (VP REIMBURSMENT)
(419) 996-5119
Entity
Organization
Contact information
Practice address
12720 MCMANUS BLVD STE 100, NEWPORT NEWS, VA 23602-4414
(757) 947-3740
(757) 947-3745
Mailing address
12720 MCMANUS BLVD STE 100, NEWPORT NEWS, VA 23602-4441
(757) 947-3740
(757) 947-3745
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004517
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629414867
—
VA
01
—
2140328
PK
—
Enumeration date
05/15/2013
Last updated
12/09/2025
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