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Contact Information

COMMUNITY PHCY OF SOUTH BOSTON,INC
2202 BEECHMONT RD
SOUTH BOSTON, VA24592-1614
 Phone: 434-575-7988
 Fax: 434-575-1358
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for COMMUNITY PHCY OF SOUTH BOSTON,INC

NPI Number 1700891306
LBN Legal business name COMMUNITY PHCY OF SOUTH BOSTON,INC
Authorized official SAMUEL FISHER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/30/2006
Last updated 11/07/2011 - About 15 years ago
Identifiers
VA License # 0201001935
VA Medicaid 8508259
Other 4809628 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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