MEDICARE: SITTER-BARFOOT VETERANS CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336L0003X	Long Term Care Pharmacy	0201004198	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2106323	OTHER		PK

General Provider Information

NPI Number	:	1083800221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SITTER-BARFOOT VETERANS CARE CENTER

Provider Business Mailing Address
First Line	:	1601 BROAD ROCK BLVD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23224-4923
Country	:	US
Telephone Number	:	804-371-8000
Fax Number	:	804-230-2097

Provider Business Practice Location Address
First Line	:	1601 BROAD ROCK BLVD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23224-4923
Country	:	US
Telephone Number	:	804-371-8000
Fax Number	:	804-230-2097

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	GHULAM NESSAR
Credential	:
Telephone Number	:	804-371-8000

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	03/01/2017

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