Organization
CLINCH VALLEY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD L STANSBURY II (OWNER)
(276) 988-4871
Entity
Organization
Contact information
Practice address
160 MARTINGALE DR, TAZEWELL, VA 24651-7000
(276) 988-4871
(276) 988-6966
Mailing address
PO BOX 548, TAZEWELL, VA 24651-0548
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0201002840
VA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0141752000
—
WV
01
—
4809983
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8502374
—
VA
Enumeration date
12/18/2006
Last updated
06/19/2023
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