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Contact Information

FORT CHISWELL PHARMACY INC
791 FORT CHISWELL RD
SUITE B
MAX MEADOWS, VA24360-4139
 Phone: 276-637-3178
 Fax: 276-637-4158
 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 FORT CHISWELL PHARMACY INC

NPI Number 1992802821
LBN Legal business name FORT CHISWELL PHARMACY INC
Authorized official STACY PETRUNYAK - (PHARMACIST IN CHARGE)
Entity Organization
Organization subpart 1 No
Enumeration date 09/20/2006
Last updated 11/10/2016 - About 10 years ago
Identifiers
VA License # 0201002590
VA Medicaid 8504156
Other 2104830 PK
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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