Organization
APPOMATTOX DRUG STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAMIE D MITCHELL (GENERAL MANAGER)
(434) 352-7161
Entity
Organization
Contact information
Practice address
2046 CONFEDERATE BLVD, APPOMATTOX, VA 24522-4097
(434) 352-7161
(434) 352-9466
Mailing address
PO BOX 489, APPOMATTOX, VA 24522-0489
(434) 352-7161
(434) 352-9466
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009106545
—
VA
Enumeration date
01/09/2007
Last updated
12/11/2023
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