Organization
BLAND COUNTY PHARMACY
Active
Other names
BLAND COUNTY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL KEGLEY (PIC)
(276) 688-4204
Entity
Organization
Contact information
Practice address
12315 GRAPEFIELD RD, BASTIAN, VA 24314-4547
(276) 688-4204
(276) 688-2450
Mailing address
12315 GRAPEFIELD RD, BASTIAN, VA 24314-4547
(276) 688-4204
(276) 688-2450
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201001869
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2103596
PK
—
05
—
8512400
—
VA
Enumeration date
09/20/2006
Last updated
01/18/2017
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