Organization
PROFESSIONAL PHARMACY OF DANVILLE
Active
Other names
PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JACK THOMSON II RPH (OWNER)
(434) 793-2221
Entity
Organization
Contact information
Practice address
130 WATSON ST, DANVILLE, VA 24541-2835
(434) 793-2221
(434) 797-9722
Mailing address
130 WATSON ST, DANVILLE, VA 24541-2835
(434) 793-2221
(434) 797-9722
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201000675
VA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008502161
—
VA
01
—
4805860
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2006
Last updated
12/15/2010
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