Organization
SMOKEYRUN, LLC
Active
Other names
Goolrick's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER CONDER (OWNER/PHARMACIST)
(804) 239-5803
Entity
Organization
Contact information
Practice address
901 CAROLINE ST, FREDERICKSBURG, VA 22401-5807
(540) 373-3411
(540) 373-9370
Mailing address
901 CAROLINE ST, FREDERICKSBURG, VA 22401-5807
(540) 373-3411
(540) 373-9370
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0201002870
VA
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168193
PK
—
Enumeration date
03/13/2017
Last updated
03/13/2017
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