Organization
SPENCERS DRUG STORE INC
Active
Other names
Spencers Drug Store Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KERI YANCEY (OWNER)
(434) 292-3132
Entity
Organization
Contact information
Practice address
100 N MAIN ST, BLACKSTONE, VA 23824-1424
(434) 292-3132
(434) 292-6467
Mailing address
100 N MAIN ST, BLACKSTONE, VA 23824-1424
(434) 292-3132
(434) 292-6467
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201000758
VA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144016
PK
—
Enumeration date
12/11/2006
Last updated
11/29/2016
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