Organization
MEDICAL PLAZA PHARMACY
Active
Organization
MEDICAL PLAZA PHARMACY
Active
Other names
MEDICAL PLAZA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY WHEELER (PIC)
(276) 596-6600
Entity
Organization
Contact information
Practice address
2951 FRONT ST STE 1850, RICHLANDS, VA 24641-2064
(276) 596-6600
(276) 596-6626
Mailing address
2951 FRONT ST STE 1850, RICHLANDS, VA 24641-2064
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201002105
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006190003
—
VA
01
—
4818829
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
8514445
—
VA
Enumeration date
07/30/2006
Last updated
11/25/2008
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