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Organization

IMGRX EAST, LLC

Active
Other names
Southwest Virginia Community Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN REW (GENERAL COUNSEL & COO)
(510) 770-6343
Entity
Organization

Contact information

Practice address
2195 EUCLID AVE STE 6, BRISTOL, VA 24201-3655
(512) 596-2930
(760) 859-3614
Mailing address
1999 HARRISON ST STE 1530, OAKLAND, CA 94612-4730
(510) 770-6343
(512) 233-5828

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
09/20/2016
Last updated
01/01/2019
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