National Provider Identifier Database

GLOUCESTER MATHEWS CARE CLINIC
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

GLOUCESTER MATHEWS CARE CLINIC
6031 INDUSTRIAL DR
GLOUCESTER COURTHOUSE, VA23061-3767
Phone: 804-642-9515
Fax: 804-684-3691
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for GLOUCESTER MATHEWS CARE CLINIC

NPI Number 1295740835
Legal business name
LBN
GLOUCESTER MATHEWS CARE CLINIC
Authorized official KERRY DANACEAU - (PIC)
Entity Organization
Organization subpart No
Enumeration date 07/30/2006
Last updated 09/19/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • VA License #: 0201003539
  • Other: 2104104 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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