Organization
BERRYVILLE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL VINSON (OWNER)
(540) 955-3095
Entity
Organization
Contact information
Practice address
8 W MAIN ST, BERRYVILLE, VA 22611-1341
(540) 955-2063
(540) 955-3365
Mailing address
8 W MAIN ST, BERRYVILLE, VA 22611-1341
(540) 955-1058
(540) 955-3365
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0201001553
VA
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4804921
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8505071
—
VA
Enumeration date
09/20/2006
Last updated
03/16/2010
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