Organization
MODERN PHARMACY INC
Active
Other names
MODERN PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN MILAM PHARM D (OWNER)
(434) 793-5711
Entity
Organization
Contact information
Practice address
155 S MAIN ST, DANVILLE, VA 24541-2921
(434) 793-5711
(434) 792-2516
Mailing address
155 S MAIN ST, DANVILLE, VA 24541-2921
(434) 793-5711
(434) 792-2516
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201000491
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0925669
—
NC
01
—
2102444
PK
—
05
—
8502609
—
VA
Enumeration date
04/27/2006
Last updated
11/21/2014
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