Organization
CENTERTOWN PHARMACY LLC
Active
Organization
CENTERTOWN PHARMACY LLC
Active
Other names
EAST LAKE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
G BRUCE THOMPSON RPH (GM)
(540) 587-0555
Entity
Organization
Contact information
Practice address
10102 LEESVILLE RD, LYNCH STATION, VA 24571-2210
(540) 587-0555
(540) 587-8741
Mailing address
10102 LEESVILLE RD, LYNCH STATION, VA 24571-2210
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0201004056
VA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4839049
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/12/2006
Last updated
09/11/2025
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