Organization
PERSONALMED VIRGINIA PHARMACY SERVICES
Active
Parent organization
PERSONALMED LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PERSONALMED LLC
Authorized official
DELFORD DOHERTY PHARM.D., PH.D., MPH (VP MANAGED CARE SERVICES)
(844) 901-7832
Entity
Organization
Contact information
Practice address
12007 SUNRISE VALLEY DR STE 110, RESTON, VA 20191-3460
(844) 901-7832
(281) 305-3989
Mailing address
10370 RICHMOND AVE STE 230, HOUSTON, TX 77042-4141
(844) 901-7832
(281) 305-3989
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
09/27/2017
Last updated
09/27/2017
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