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Contact Information

KYLE JANSEN
1906 BELLEVIEW AVE SE
ROANOKE, VA24014-1838
 Phone: 540-759-1058
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for

NPI # 1558117267
Entity Organization
Organization subpart 1 Not specified
Enumeration date 04/24/2024
Last updated 04/24/2024 - About 2 years ago
Identifiers
VA License # 0202221323
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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