Organization
EXPRESS RX
Active
Other names
express rx
Organization subpart
No
Provider details
NPI number
Authorized official
RICK BERGERON (OWNER)
(757) 787-1540
Entity
Organization
Contact information
Practice address
18255 FIRST ST, KELLER, VA 23422
(757) 787-1540
(757) 787-2007
Mailing address
PO BOX 381, KELLER, VA 23401-0381
(757) 787-1540
(757) 787-2007
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004426
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4843480
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/27/2011
Last updated
11/29/2011
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