Organization
PURCELLVILLE PHARMACY
Active
Other names
Purcellville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SYAM BANDI (OWNER)
(815) 342-7535
Entity
Organization
Contact information
Practice address
609 E MAIN ST STE Q, PURCELLVILLE, VA 20132-3182
(540) 751-9750
(540) 441-7099
Mailing address
609 E MAIN ST STE Q, PURCELLVILLE, VA 20132-3182
(540) 751-9750
(540) 441-7099
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0201004721
VA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770939779
—
VA
01
—
2162073
PK
—
Enumeration date
05/09/2016
Last updated
10/07/2016
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