Organization
TARGET
Active
Organization
TARGET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOEL FEMINELLA (PHARMACIST IN CHARGE)
(804) 520-2280
Entity
Organization
Contact information
Practice address
721 SOUTHPARK BLVD, COLONIAL HEIGHTS, VA 23834-3606
(804) 520-2280
(804) 431-3211
Mailing address
721 SOUTHPARK BLVD, COLONIAL HEIGHTS, VA 23834-3606
(804) 520-2280
(804) 431-3211
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
0202209760
VA
251S00000X
Community/Behavioral Health Agency
Primary
PS43913
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202209760
BOARD OF PHARMACY LICENSE
VA
01
—
PS43913
BOARD OF PHARMACY LICENSE
FL
Enumeration date
05/23/2014
Last updated
05/23/2014
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