Organization
MICHAELS PHARMACY
Active
Organization
MICHAELS PHARMACY
Active
Other names
MICHAELS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOHNSON RPH (PRES PIC)
(276) 676-2900
Entity
Organization
Contact information
Practice address
101 CHARWOOD DR, ABINGDON, VA 24210-2576
(276) 676-2900
(276) 676-2915
Mailing address
101 CHARWOOD DR, ABINGDON, VA 24210-2576
(276) 676-2900
(276) 676-2915
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201003687
VA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008507261
—
VA
05
—
009106588
—
VA
01
—
4835154
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/10/2006
Last updated
01/17/2012
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